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. 2023 Jul 27;30(8):7229-7240.
doi: 10.3390/curroncol30080524.

Safety and Effectiveness of Chemotherapy in Elderly Biliary Tract Cancer Patients

Takeshi Okamoto  1 , Tsuyoshi Takeda  1 , Takashi Sasaki  1 , Tsuyoshi Hamada  1   2 , Takafumi Mie  1 , Takahiro Ishitsuka  1 , Manabu Yamada  1 , Hiroki Nakagawa  1 , Tatsuki Hirai  1 , Takaaki Furukawa  1 , Akiyoshi Kasuga  1 , Masato Ozaka  1 , Naoki Sasahira  1
Affiliations

Safety and Effectiveness of Chemotherapy in Elderly Biliary Tract Cancer Patients

Takeshi Okamoto et al. Curr Oncol. .

Abstract

The safety and effectiveness of chemotherapy in elderly patients with biliary tract cancer (BTC) remain unclear. Therefore, we retrospectively reviewed patients who underwent chemotherapy for locally advanced, metastatic, or recurrent BTC at our institution from January 2016 to December 2021. Of the 283 included patients, 91 (32.5%) were aged 75 years or older when initiating chemotherapy. Elderly patients were more likely than non-elderly patients to receive monotherapy with gemcitabine or S-1 (58.7% vs. 9.4%, p < 0.001) and were less likely to experience grade 3-4 toxicities (55.4% vs. 70.2%, p = 0.015). The rates of termination due to intolerance (6.5% vs. 5.8%, p = 0.800) and transition to second-line chemotherapy (39.1% vs. 40.3%, p = 0.849) were similar between groups. In the overall cohort, age was not an independent predictor of overall survival (OS). Within the elderly cohort, there were no differences in severe adverse events between patients receiving monotherapy and combination therapy (50.0% vs. 63.2%, p = 0.211). Median OS was longer in the combination therapy group (10.4 vs. 14.1 months; p = 0.010); however, choice of monotherapy was not an independent predictor of overall survival. Monotherapy appears to be a viable alternative in selected elderly BTC patients.

Keywords: S-1; age; cholangiocarcinoma; cisplatin; combination chemotherapy; gemcitabine; monotherapy; tolerability.

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Conflict of interest statement

N.S. received scholarship donations from Taiho Pharmaceutical and Chugai Pharmaceutical towards his institution and honoraria from Taiho Pharmaceutical, Eisai, Chugai Pharmaceutical, Takeda Pharmaceutical, and AstraZeneca. All other authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Kaplan–Meier curves for the overall cohort. (a) Overall survival; (b) progression-free survival. CI: confidence interval; OS: overall survival; PFS: progression-free survival.
Figure 2
Figure 2
Kaplan–Meier curves for the elderly cohort. (a) Overall survival; (b) progression-free survival. CI: confidence interval; OS: overall survival; PFS: progression-free survival.
See this image and copyright information in PMC

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