Folfirinox Shows Promise As A Second-line Option For Advanced Biliary Tract Cancer

Biliary tract cancers, including intrahepatic, perihilar, and extrahepatic cholangiocarcinoma and gallbladder cancer, are among nan astir fierce gastrointestinal malignancies. Treatment options stay constricted erstwhile nan illness progresses aft first-line chemotherapy, and endurance seldom exceeds 1 year.

To reside this, nan squad of researchers led by Professor Yun Hak Kim from Pusan National University, analyzed 12 years of objective information from 54 patients treated astatine Yonsei Severance Hospital and mixed nan results pinch a systematic reappraisal and meta-analysis of 21 studies from astir nan world. This insubstantial was made disposable online connected 05 September 2025 successful nan diary International Journal of Surgery.

The mixed grounds suggests that FOLFIRINOX whitethorn supply amended progression-free and wide endurance than presently recommended regimens specified arsenic FOLFOX, FOLFIRI, aliases nal-IRI/FL.

"We conducted a meta-analysis integrating 12 years of real-world information connected nan usage of FOLFIRINOX aliases mFOLFIRINOX arsenic salvage curen successful patients pinch precocious BTC treated astatine nan Division of Gastroenterology, Department of Internal Medicine, Severance Hospital, on pinch each disposable published studies connected second-line chemotherapy regimens for precocious BTC," said Prof. Kim.

In this study, patients receiving FOLFIRINOX achieved a median progression-free endurance of 4.2 months and an wide endurance of 11.4 months. In nan accompanying meta-analysis of 21 studies, FOLFIRINOX demonstrated numerically longer progression-free and wide endurance compared pinch presently utilized second-line regimens specified arsenic FOLFOX, FOLFIRI, and nal-IRI/FL.

Still, nan authors be aware that toxicity remains significant. Nearly 40 percent of patients developed terrible neutropenia, requiring dose adjustments aliases further aesculapian support. The squad emphasizes that FOLFIRINOX should beryllium reserved for fresh patients nether adjacent supervision until further prospective tests corroborate its broader safety.

Beyond short-term survival, nan study highlights nan imaginable to merge biomarker-based action and supportive strategies specified arsenic granulocyte colony-stimulating facet to mitigate toxicity. Future investigation whitethorn besides research pairing FOLFIRINOX pinch immunotherapies aliases molecular-targeted drugs. "Our findings propose that FOLFIRINOX whitethorn connection a imaginable use arsenic a second-line curen action for BTC pursuing progression connected first-line chemotherapy," concluded Prof. Kim.

This insubstantial provides an evidence-based instauration for clinicians considering curen options aft first-line chemotherapy nonaccomplishment and whitethorn guideline updates to early BTC guidance guidelines.