Standardized Response Assessment in Patients with Advanced Cholangiocarcinoma Treated with Personalized Therapy

Ursprung, Stephan; Thaiss, Wolfgang; Beha, Janina; Möller, Yvonne; Malek, Nisar P.; Beer, Meinrad; Gaidzik, Verena I.; Seufferlein, Thomas; Beer, Ambros J.; Nikolaou, Konstantin; Reinert, Christian Philipp

doi:10.3390/jpm14121143

Open AccessArticle

Standardized Response Assessment in Patients with Advanced Cholangiocarcinoma Treated with Personalized Therapy

by

Stephan Ursprung

¹

,

Wolfgang Thaiss

^2,3,

Janina Beha

⁴,

Yvonne Möller

⁴,

Nisar P. Malek

^5,6,7,

Meinrad Beer

^3,8,9

,

Verena I. Gaidzik

^10,11,

Thomas Seufferlein

^11,12,

Ambros J. Beer

²

,

Konstantin Nikolaou

^1,6,7

and

Christian Philipp Reinert

^1,*

¹

Department of Radiology, University Hospital Tuebingen, 72076 Tübingen, Germany

²

Department of Nuclear Medicine, Ulm University Medical Center, 89081 Ulm, Germany

³

Department of Radiology, Ulm University Medical Center, 89081 Ulm, Germany

⁴

Center for Personalized Medicine, University Hospital Tuebingen, 72076 Tübingen, Germany

⁵

Department of Internal Medicine I, University Hospital, Eberhard-Karls University, 72076 Tübingen, Germany

⁶

Cluster of Excellence, Image Guided and Functionally Instructed Tumor Therapies, Eberhard-Karls University, 72076 Tübingen, Germany

⁷

German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany

⁸

National Center for Tumour Diseases SouthWest: Tuebingen-Stuttgart/Ulm, 89070 Ulm, Germany

⁹

Innovative Imaging in Surgical Oncology, Ulm University Hospital, 89070 Ulm, Germany

¹⁰

Department of Internal Medicine I, Ulm University Hospital, 89081 Ulm, Germany

¹¹

Center of Personalised Medicine, University Hospital Ulm, 89081 Ulm, Germany

¹²

Department of Internal Medicine III, Ulm University Hospital, 89081 Ulm, Germany

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Author to whom correspondence should be addressed.

J. Pers. Med. 2024, 14(12), 1143; https://doi.org/10.3390/jpm14121143

Submission received: 23 September 2024 / Revised: 5 November 2024 / Accepted: 28 November 2024 / Published: 6 December 2024

(This article belongs to the Section Methodology, Drug and Device Discovery)

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Abstract

Background/Objectives: Current guidelines recommend Cisplatin/Gemcitabine/Durvalumab as first-line treatment for inoperable or recurrent cholangiocarcinoma (CCA). Molecular tumor boards (MTB) have the expertise to support organ-specific tumor boards with evidence-based treatment recommendations for subsequent lines of treatment, based on genomic tumor data and scientific evidence. This study evaluates the adoption of an MTB at a comprehensive cancer center in Germany and whether actionable genetic alterations are associated with specific imaging phenotypes. Methods: Patients with CCA referred to MTB were enrolled from May 2019 to September 2021. For comparison, a cohort of patients from a second center was included. Data on treatment recommendations, regimens, and survival were collected from prospective registries. Baseline and follow-up contrast-enhanced CT were analyzed according to RECIST 1.1. The chi-square test and t-test were used to compare categorical and continuous variables. Results: 583 patients were referred to the MTB, and 92 patients (47 female/51%) with a mean age of 60.3 ± 11.2 were referred for CCA treatment. 65/92 patients harbored 1–3 targetable mutations. Liver metastases were more frequently observed in patients with targetable mutations (84% vs. 62%). Metastasis to the liver and lung was associated with increased sums of diameters (93 mm and 111 mm vs. 40/73 mm in patients with no liver/lung metastasis). The number of metastases in individual organs was unrelated to treatment targets. Follow-up was available for 25 patients with a median time until imaging progression of 23 weeks. Progression occurred as target progression in 63%, nontarget progression in 13%, and appearance of new lesions in 63%. Conclusions: Most patients with CCA harbored targetable mutations, some were related to disease patterns on imaging. The pattern of treatment response and progression was as diverse as the metastatic spread.

Keywords: cholangiocarcinoma; molecular tumor board; personalized cancer care; imaging

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MDPI and ACS Style

Ursprung, S.; Thaiss, W.; Beha, J.; Möller, Y.; Malek, N.P.; Beer, M.; Gaidzik, V.I.; Seufferlein, T.; Beer, A.J.; Nikolaou, K.; et al. Standardized Response Assessment in Patients with Advanced Cholangiocarcinoma Treated with Personalized Therapy. J. Pers. Med. 2024, 14, 1143. https://doi.org/10.3390/jpm14121143

AMA Style

Ursprung S, Thaiss W, Beha J, Möller Y, Malek NP, Beer M, Gaidzik VI, Seufferlein T, Beer AJ, Nikolaou K, et al. Standardized Response Assessment in Patients with Advanced Cholangiocarcinoma Treated with Personalized Therapy. Journal of Personalized Medicine. 2024; 14(12):1143. https://doi.org/10.3390/jpm14121143

Chicago/Turabian Style

Ursprung, Stephan, Wolfgang Thaiss, Janina Beha, Yvonne Möller, Nisar P. Malek, Meinrad Beer, Verena I. Gaidzik, Thomas Seufferlein, Ambros J. Beer, Konstantin Nikolaou, and et al. 2024. "Standardized Response Assessment in Patients with Advanced Cholangiocarcinoma Treated with Personalized Therapy" Journal of Personalized Medicine 14, no. 12: 1143. https://doi.org/10.3390/jpm14121143

APA Style

Ursprung, S., Thaiss, W., Beha, J., Möller, Y., Malek, N. P., Beer, M., Gaidzik, V. I., Seufferlein, T., Beer, A. J., Nikolaou, K., & Reinert, C. P. (2024). Standardized Response Assessment in Patients with Advanced Cholangiocarcinoma Treated with Personalized Therapy. Journal of Personalized Medicine, 14(12), 1143. https://doi.org/10.3390/jpm14121143

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Standardized Response Assessment in Patients with Advanced Cholangiocarcinoma Treated with Personalized Therapy

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