{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T20:51:37Z","timestamp":1783975897844,"version":"3.55.0"},"reference-count":24,"publisher":"Wiley","issue":"24","license":[{"start":{"date-parts":[[2019,8,27]],"date-time":"2019-08-27T00:00:00Z","timestamp":1566864000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100011475","name":"Cholangiocarcinoma Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011475","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2019,12,15]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Although gemcitabine plus platinum chemotherapy is the established first\u2010line regimen for advanced biliary cancer (ABC), there is no standard second\u2010line therapy. This study evaluated current practice and outcomes for second\u2010line chemotherapy in patients with ABC across 3 US academic medical centers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Institutional registries were reviewed to identify patients who had received second\u2010line chemotherapy for ABC from April 2010 to March 2015 along with their demographics, diagnoses and staging, treatment histories, and clinical outcomes. Overall survival from the initiation of second\u2010line chemotherapy (OS2) was estimated with Kaplan\u2010Meier methods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>This study identified 198 patients with cholangiocarcinoma (intrahepatic [61.1%] or extrahepatic [14.1%]) or gallbladder carcinoma (24.8%); 52% received at least 3 lines of systemic chemotherapy. The median OS2 was 11\u00a0months (95% confidence interval [CI], 8.8\u201013.1\u00a0months). The median OS2 for patients with intrahepatic cholangiocarcinoma was 13.4\u00a0months (95% CI, 10.7\u201017.8\u00a0months), which was longer than that for patients with extrahepatic cholangiocarcinoma (6.8\u00a0months; 95% CI, 5\u201010.6\u00a0months) or gallbladder carcinoma (9.4\u00a0months; 95% CI, 7.2\u201012.3\u00a0months; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.018). The median time to second\u2010line treatment failure was 2.2\u00a0months (95% CI, 1.8\u20102.7\u00a0months), and it was similar across tumor locations (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.60).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this large cohort of patients with ABC treated across 3 academic medical centers after the failure of first\u2010line chemotherapy, the time to treatment failure on standard therapies was short, although the median OS2 was longer than has been reported previously, and more than half of the patients received additional lines of treatment. This multicenter collaboration represents the largest cohort studied to date of second\u2010line chemotherapy for ABC and provides a contemporary benchmark for future clinical trials.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.32463","type":"journal-article","created":{"date-parts":[[2019,8,27]],"date-time":"2019-08-27T16:24:50Z","timestamp":1566923090000},"page":"4426-4434","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":63,"title":["Second\u2010line chemotherapy in advanced biliary cancers: A retrospective, multicenter analysis of outcomes"],"prefix":"10.1002","volume":"125","author":[{"given":"Maeve A.","family":"Lowery","sequence":"first","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura W.","family":"Goff","sequence":"additional","affiliation":[{"name":"Vanderbilt\u2010Ingram Cancer Center Vanderbilt University Nashville 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