Until recently, biliary tract cancers were relegated to orphan cancer status: rare cancers such as cholangiocarcinoma and gallbladder cancers. These aggressive malignancies were lumped together, historic trials were small, and patients were stuck with gemcitabine-cisplatin chemotherapy as the only real option, a regimen that hadn't changed for almost a decade. Then two trials cracked the field open. BILCAP, reported in 2019, gave resected patients their first evidence-based reason to take adjuvant capecitabine, pushing median survival from around three years to over four. And in 2022, TOPAZ-1 became the first trial to prove immunotherapy has a place in biliary cancer. Durvalumab was added to standard chemo, and in the latest three-year follow-up, it cut the risk of death by over a quarter. Together, these two trials didn't just add drugs to a protocol; they turned biliary tract cancer from an afterthought into a disease with modern treatment pathways.

Trials Discussed on Today's Episode:

BILCAP

TOPAZ-1

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Art courtesy of Taryn Silver

Music courtesy of AlisiaBeats: https://pixabay.com/users/alisiabeats-39461785/

Disclaimer: This podcast is for educational purposes only. If you are unwell, seek medical advice.

Oncology for the Inquisitive Mind is recorded with the support of education grants from our foundation partners Pfizer and Merck Pharmaceuticals. Our partners have access to the episode at the same time you do and have no editorial control over the content.

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