Multinational retrospective study of impact of molecular alterations on efficacy of first-line CGD for advanced biliary tract cancer

A retrospective study at 39 centers across 11 countries investigated the impact of molecular alterations on the efficacy of first-line cisplatin-gemcitabine-durvalumab combination for advanced biliary tract cancer. In multivariate analysis, SMAD4 mutations were associated with improved progression-free survival and overall survival, whereas TP53 mutations were associated with worse PFS and TERT mutations were associated with worse OS. In subgroup analyses, TP53 mutation negatively impacted PFS and OS in intrahepatic cholangiocarcinoma, while KRAS mutations were associated with worse PFS in extrahepatic cholangiocarcinoma. No gene alterations were linked to outcomes in gallbladder cancer. The authors conclude that these results provide valuable insights for personalized treatment strategies in aBTC.