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Review
. 2023 Dec:192:104146.
doi: 10.1016/j.critrevonc.2023.104146. Epub 2023 Sep 28.

Diagnosis and treatment of cholangiocarcinoma in Italy: A Delphi consensus statement

Lorenza Rimassa  1 , Giovanni Brandi  2 , Monica Niger  3 , Nicola Normanno  4 , Davide Melisi  5 ; Delphi Panel Members
Affiliations
Review

Diagnosis and treatment of cholangiocarcinoma in Italy: A Delphi consensus statement

Lorenza Rimassa et al. Crit Rev Oncol Hematol. 2023 Dec.

Abstract

Background: Clinical practice guidelines for the management of cholangiocarcinoma (CCA)/biliary tract cancer recommend genomic profiling to guide treatment decisions. Variable access to such profiling across Italy means many oncologists are unfamiliar with when and how to conduct genetic testing and prescribe targeted treatments.

Methods: A Scientific Board of Italian oncologists who treat CCA (the authors) developed recommendations, based on recent clinical evidence, for using molecular testing in diagnosing, assessing, and treating CCA in Italy. The Delphi process was used to reach consensus on these recommendations among 38 Italian oncologists. Consensus was considered to be met if ≥ 66.7 % of the panel agreed or strongly agreed with each statement.

Findings: Consensus was reached on 28 statements across four themes: (1) epidemiology and risk factors; (2) diagnosis, including molecular diagnosis; (3) treatment selection; and (4) treatment safety.

Interpretation: These recommendations should aid Italian clinicians in selecting appropriate treatment options for their patients.

Keywords: Biliary tract cancer; Cholangiocarcinoma; Delphi consensus; Gene expression profile; Molecular targeted therapies.

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Conflict of interest statement

Declaration of Competing Interest LR has received consulting fees from AstraZeneca, Basilea, Bayer, BMS, Eisai, Exelixis, Genenta, Hengrui, Incyte, Ipsen, IQVIA, Jazz Pharmaceuticals, MSD, Nerviano Medical Sciences, Roche, Servier, Taiho Oncology and Zymeworks; lecture fees from AstraZeneca, Bayer, BMS, Eisai, Incyte, Ipsen, Merck Serono, Roche and Servier; travel expenses from AstraZeneca; and institutional research funding from Agios, AstraZeneca, BeiGene, Eisai, Exelixis, Fibrogen, Incyte, Ipsen, Lilly, MSD, Nerviano Medical Sciences, Roche and Zymeworks. GB has received research grants from Incyte and IPSEN and consulting fees from Incyte, Eli-Lilly and Taiho. MN has received funding for travel expenses from AstraZeneca, speaker honoraria from Accademia della Medicina and Incyte; honoraria from Sandoz, Medpoint SRL, Incyte and Servier for editorial collaboration; and consultant honoraria from EMD Serono, Basilea Pharmaceutica, Incyte, MSD Italia, Servier, AstraZeneca and Taiho. NN has received speaker’s fees and/or fees for participation in advisory boards from MSD, Bayer, Biocartis, Illumina, Incyte, Roche, MERCK, Thermofisher, AstraZeneca, Eli Lilly, Novartis and Janssen; and financial support for research projects from MERCK, Thermofisher, QIAGEN, Roche, AstraZeneca, Biocartis and Illumina. DM has received research grants from Celgene, Evotec, Shire, Incyte, Servier, iOnctura and Roche; and personal fees for consulting from Shire, Incyte, Servier, iOnctura, Baxter, Eli Lilly and Evotec.

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