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  • gavin
    Moderator

    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/

    gavin
    Moderator

    FIGHT-302: first-line pemigatinib vs gemcitabine plus cisplatin for advanced cholangiocarcinoma with FGFR2 rearrangements

    https://pubmed.ncbi.nlm.nih.gov/32677452/

    mirandajhouse
    Participant

    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!

    mirandajhouse
    Participant

    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!

    gavin
    Moderator

    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

    gavin
    Moderator

    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

    gavin
    Moderator

    NUC-1031/cisplatin versus gemcitabine/cisplatin in untreated locally advanced/metastatic biliary tract cancer (NuTide:121).

    https://www.ncbi.nlm.nih.gov/pubmed/32374623

    gavin
    Moderator

    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

    gavin
    Moderator

    A Phase 3, First Line Study of Pemigatinib vs Gemcitabine/Cisplatin in Patients with Cholangiocarcinoma

    A Phase 3, First Line Study of Pemigatinib vs Gemcitabine/Cisplatin in Patients with Cholangiocarcinoma

    https://clinicaltrials.gov/ct2/show/NCT03656536

    Gavin

    gavin
    Moderator

    Durvalumab or Placebo in Combination With Gemcitabine/Cisplatin in Patients With 1st Line Advanced Biliary Tract Cancer (TOPAZ-1) (TOPAZ-1)

    Durvalumab or Placebo in Combination With Gemcitabine/Cisplatin in Patients With 1st Line Advanced Biliary Tract Cancer (TOPAZ-1) (TOPAZ-1)

    https://clinicaltrials.gov/ct2/show/NCT03875235

    Gavin

    gavin
    Moderator

    Phase II study of copanlisib (BAY 80-6946) in combination with gemcitabine and cisplatin in advanced cholangiocarcinoma

    Phase II study of copanlisib (BAY 80-6946) in combination with gemcitabine and cisplatin in advanced cholangiocarcinoma

    Gavin

    gavin
    Moderator

    A Phase 3, First Line Study of Pemigatinib vs Gemcitabine/Cisplatin in Patients with Cholangiocarcinoma

    A Phase 3, First Line Study of Pemigatinib vs Gemcitabine/Cisplatin in Patients with Cholangiocarcinoma

    https://clinicaltrials.gov/ct2/show/NCT03656536

    Gavin

    gavin
    Moderator

    Gemcitabine Plus Cisplatin Chemotherapy Prolongs the Survival in Advanced Hilar Cholangiocarcinoma: A Large Multicenter Study.

    https://www.ncbi.nlm.nih.gov/pubmed/32118610

    gavin
    Moderator

    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 of the German registry of incidental gallbladder carcinoma platform (GR)- the AIO/ CALGP/ ACO- GAIN-trial.

    https://www.ncbi.nlm.nih.gov/pubmed/32059704

    #99655
    Chiron
    Participant

    Hello everyone,

    I would like to introduce myself. My name is KC. My mother was diagnosed with Extrahepatic CC, Stage III. When this happened, I buried myself in medical journals / treatments and burned myself out doing research. I have been visiting here on and off for a while now. I just recently decided to become part of your wonderful community after a very difficult decision I made recently. Of course, all decisions are made by the patient. But as a caregiver, your opinions carry so much weight that the decision is indirectly yours. I’m grateful for finding this site and the wealth of information here is priceless. So much easier to read over doctor jargon.

    I tried to get my mother in the TOPAZ-1 clinical trial. However, after 2 attempts, the doctor was not able to collect a biopsy sample via FNA (Fine Needle Aspiration). The option the doctor gave us was that if the surgeon was going to attempt another biopsy, he might have to punch a hole through the bile duct in order to get to the mass. If we were to take that option, treatment would be delayed again for at least another 3 weeks, there may be a complication with the damage to the duct, and ultimately might not even succeed. Since it has already been 12 weeks since Kaiser discovered her cancer, I did not want to delay any treatment any longer and give the tumor the time to grow and metastasize. The second opinion I got from the City of Hope doctor supported Kaiser standard treatment of Gem/Cis ASAP. He also mentioned that just because the FNA failed, doesn’t mean that she cannot attempt another biopsy later on. But without a biopsy to determine is MSI is present, there is no way to for her to be prescribed Pembrolizumab (Keytruda). Participation in the clinical trial would also not allow my mom to receive radiation therapy on the side. So, in front of the doc, I gave my mom all the facts, and recommended she just start Gem/Cis that day. Tomorrow will be her 2nd treatment, 1st cycle. But, weighing the decision of attempting a 3rd biopsy vs. starting Gem/Cis now, still feels heavy on my mind. I’m not sure if I made the right recommendation.

    I looked up a full body 3D anatomy model and 3D pancreatic model so I understand how difficult it is to get to the tumor location. Has anyone else experienced difficulty with attaining a biopsy? Is a biopsy taken after chemo treatments still viable for molecular testing? Living in the US, can we seek surgical treatment in Toronto, Canada? Since Kaiser would not cover Proton Therapy, we’ll pay out of pocket for Proton Therapy since California Protons offer a reduction in pricing for people who are denied by their insurance company. These are the questions I’m currently looking into.

    I think sharing is therapy for the caregiver. I feel better after writing this. Much love everyone.

    • This topic was modified 5 months, 3 weeks ago by rick.
    • This topic was modified 5 months, 3 weeks ago by bglass.
    • This topic was modified 5 months, 3 weeks ago by bglass.
    • This topic was modified 5 months, 3 weeks ago by bglass.
    • This topic was modified 5 months, 3 weeks ago by bglass.
Viewing 15 results - 1 through 15 (of 634 total)