Multinational study of factors associated with reaching maintenance therapy among patients receiving durvalumab for advanced biliary tract cancer

Standard of care first-lin systemic treatment for advanced biliary tract cancer includes chemo-immunotherapy with gemcitabine, cisplatin, and durvalumab for eight cycles, followed by durvalumab monotherapy maintance. A retrospective study at 38 centers in 12 countries investigated baseline clinical and molecular differences between patients with early progression and those who reach durvalumab monotherapy. Among 448 aBTC patients, 50.7% reached durvalumab monotherapy. Compared with patients with early progression, those reaching maintenance were more likely to be age 70 years or older, have an ECOG performance status 0, have locally advanced disease, and an neutrophil-to-lymphocyte ratio < 3. A higher proportion of patients with BAP1 mutations reached maintenance, whereas TP53 mutations were more common in those who progressed early.