Phase 2 study of copanlisib in combination with gemcitabine and cisplatin in advanced biliary tract cancers
https://pubmed.ncbi.nlm.nih.gov/33289918/
Feasibility and efficacy evaluation of metallic biliary stents eluting gemcitabine and cisplatin for extrahepatic cholangiocarcinoma
https://pubmed.ncbi.nlm.nih.gov/32884219/
Hi Uk33,
Welcome to our community. Your uncle’s recent diagnosis was not happy news and I am sorry he is in so much pain.
His experience so far is similar to some other patients who have posted on this board. When patients are referred to surgery, often the surgeon will perform a laparoscopic procedure first to take a direct look at the tumor. The abdomen is a crowded part of the body with many organs, blood vessels, bile ducts and other features, so sometimes tumors and the extent of spread look different in person than on the images. It does happen sometimes with our patients that the cancer proves inoperable despite a more optimistic picture in the scans. When this happens it is hugely disappointing, and also the patient has a recovery to get through from the initial exploratory surgery.
Gemcitabine together with cisplatin is the workhorse chemo treatment for this cancer. Radiation is used to treat cholangiocarcinoma, but less commonly. For certain presentations of the cancer, it is reported to offer a potential benefit. Treatment options should be discussed with the doctors, to learn the expected benefits, potential side effects, and other information needed to make an informed choice.
Cholangiocarcinoma patients can experience pain, sometimes substantial, resulting from the encroachment of the tumor(s), or as a side effect of treatment. Your uncle is contending both with the cancer and with recovery from the surgery and bypass procedure. Pain can be managed, but it is very important to be proactive and to insist with doctors that they adjust pain medication to bring maximum relief to the patient. Often pain management with this cancer is trial and error – if the current regimen is not working, then the doctor should offer an alternative medication(s) or dosage(s). Also, it can take some time for the digestive tract to return to normal functioning after surgery. His doctor may be able to offer relief from issues such as bloating or constipation.
I am sorry your beloved family member is going through such a difficult time. Hopefully his doctors will offer a treatment plan to bring the cancer under control and will given him better options for pain management. Covid complicates all of our lives in many ways, but for cancer patients, covid has been a particular challenge. I hope your uncle feels better soon. Please stay in touch, take a look at the resources for patients and caregivers on the Cholangiocarcinoma Foundation website, and send any questions our way.
Take care, regards, Mary
Cisplatin and Gemcitabine Chemotherapy and Lenvatinib for Patients With Unresectable Intrahepatic Cholangiocarcinoma
https://www.clinicaltrials.gov/ct2/show/NCT04527679
GDC-0980 (apitolisib) treatment with gemcitabine and/or cisplatin synergistically reduces cholangiocarcinoma cell growth by suppressing the PI3K/Akt/mTOR pathway
https://pubmed.ncbi.nlm.nih.gov/32819590/
Treatment of Patients with Advanced Biliary Tract Cancer with Either Oxaliplatin, Gemcitabine, and Capecitabine or Cisplatin and Gemcitabine-A Randomized Phase II Trial
https://pubmed.ncbi.nlm.nih.gov/32698410/
FIGHT-302: first-line pemigatinib vs gemcitabine plus cisplatin for advanced cholangiocarcinoma with FGFR2 rearrangements
https://pubmed.ncbi.nlm.nih.gov/32677452/
Hi there – I was hoping to find out if there is anyone on this site who has had experience with Ampullary Adenocarcinoma.
My father was diagnosed with ampullary adenocarcinoma in March 2019 and he had successful Whipple Surgery in May 2020, followed by chemo for 6 months. He was given the all clear earlier this year. Unfortunately we heard last Friday that he now has Liver Metastases, Stage 4. He is otherwise pretty healthy and walks around 2 hours a day and plays golf 2 to 3 times a week (without a buggy/cart).
I am based in California but he is based in the UK and has had all the previous treatments and surgery in the UK. As we haven’t had the greatest response for potential treatments there we are exploring options in the USA (or anywhere in the world) and wanted to see if there may be some other possible treatments/surgery available to him.
The initial oncologist in the UK said that it is inoperable and they suggested the chemo drugs Gemcitabine with Cisplatin.
We have reached out to other oncologists in the UK who specialize in Bile Duct Cancers and have looked into some trials in the UK but have been told as its ampulary adenocarcinoma it wouldn’t be a match for the trial drug (Pemigatinib) (the hospital have just heard back from the sponsors and unfortunately they will not allow my father into trial screening as they think it’s very unlikely that ampullary cancers will harbour a FGFR alteration). I believe another potential trial drug that has been mentioned is Topaz 1 – we are waiting for more info about this. Anyone have any experience with Topaz-1?
We were also told that the immunotherapy drug Tecentriq (in combination with Avastin) wouldn’t work for ampulary cancer as well. Another immunotherapy drug that was suggested is Pembrolizumab – used in conjunction with Gemcitabine with Cisplatin. We are also waiting for more info on this one.
He is going to UCL Hospital in London tomorrow to do a liquid Foundation Medicine profile so I am hoping once we get this this might be useful for potential trials.
Right now, we are looking to get a second (or third or fourth) opinion and find out if there are any possible alternatives to just chemo in case it looks like the only way to get treatment/surgery is for him to come to the USA.
Any thoughts or suggestions would be greatly appreciated.
Thank you!
Hi there – I was hoping to find out if there is anyone who has had experience with Ampullary Adenocarcinoma.
My father was diagnosed with ampullary adenocarcinoma in March 2019 and he had successful Whipple Surgery in May 2020, followed by chemo for 6 months. He was given the all clear earlier this year. Unfortunately we heard last Friday that he now has Liver Metastases, Stage 4. He is otherwise pretty healthy and walks around 2 hours a day and plays golf 2 to 3 times a week (without a buggy/cart).
I am based in California but he is based in the UK and has had all the previous treatments and surgery in the UK. As we haven’t had the greatest response for potential treatments there we are exploring options in the USA (or anywhere in the world) and wanted to see if there may be some other possible treatments/surgery available to him.
The initial oncologist in the UK said that it is inoperable and they suggested the chemo drugs Gemcitabine with Cisplatin.
We have reached out to other oncologists in the UK who specialize in Bile Duct Cancers and have looked into some trials in the UK but have been told as its ampulary adenocarcinoma it wouldn’t be a match for the trial drug (Pemigatinib) (the hospital have just heard back from the sponsors and unfortunately they will not allow my father into trial screening as they think it’s very unlikely that ampullary cancers will harbour a FGFR alteration). I believe another potential trial drug that has been mentioned is Topaz 1 – we are waiting for more info about this. Anyone have any experience with Topaz-1?
We were also told that the immunotherapy drug Tecentriq (in combination with Avastin) wouldn’t work for ampulary cancer as well. Another immunotherapy drug that was suggested is Pembrolizumab – used in conjunction with Gemcitabine with Cisplatin. We are also waiting for more info on this one.
He is going to UCL Hospital in London tomorrow to do a liquid Foundation Medicine profile so I am hoping once we get this this might be useful for potential trials.
Right now, we are looking to get a second (or third or fourth) opinion and find out if there are any possible alternatives to just chemo in case it looks like the only way to get treatment/surgery is for him to come to the USA.
Any thoughts or suggestions would be greatly appreciated.
Thank you!
Efficacy and Safety of Pembrolizumab for Gemcitabine/Cisplatin-Refractory Biliary Tract Cancer: A Multicenter Retrospective Study
https://pubmed.ncbi.nlm.nih.gov/32517311/?from_term=cholangiocarcinoma&from_sort=date&from_pos=2
Neoadjuvant chemotherapy with gemcitabine plus cisplatin followed by radical liver resection versus immediate radical liver resection alone with or without adjuvant chemotherapy in incidentally detected gallbladder carcinoma after simple cholecystectomy or in front of radical resection of BTC (ICC/ECC): A phase III study utilizing the German Registry of Incidental Gallbladder Carcinoma Platform (GR)—The AIO/CALGP/ACO-GAIN-Trial.
https://meetinglibrary.asco.org/record/191834/abstract
NUC-1031/cisplatin versus gemcitabine/cisplatin in untreated locally advanced/metastatic biliary tract cancer (NuTide:121).
https://www.ncbi.nlm.nih.gov/pubmed/32374623
NUC-1031/cisplatin versus gemcitabine/cisplatin in untreated locally advanced/metastatic biliary tract cancer (NuTide:121).
https://www.ncbi.nlm.nih.gov/pubmed/32374623
https://clinicaltrials.gov/ct2/show/NCT04163900
Gavin