{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T11:36:46Z","timestamp":1758281806721,"version":"3.44.0"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T00:00:00Z","timestamp":1753228800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Biliary tract cancer is a rare tumor entity mostly diagnosed at advanced stages with poor prognosis. Since publication of the TOPAZ-1 trial, durvalumab + gemcitabine\/cisplatin has become the standard palliative first-line treatment. However, real-world evidence is inconclusive and no systematic review or meta-analysis has yet evaluated the current available literature on this topic.<\/jats:p>\n                  <jats:p>This meta-analysis, therefore, aimed to assess the effectiveness of durvalumab plus gemcitabine\/cisplatin as first-line treatment compared to the previous standard and evaluate the existing evidence of this treatment in real-world cohorts.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Trials investigating durvalumab + gemcitabine\/cisplatin as palliative first-line treatment in advanced biliary tract cancer and published in PubMed\/Medline databases between January 2020 and December 2024 were included. Studies on second-line treatment or studies investigating other than the standard chemotherapy backbones were excluded. Selection of the trials and quality assessment was conducted independently by two reviewers. Trials with a two-arm design reporting effect measures were included in the meta-analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>After screening 190 studies, 10 trials encompassing 2877 patients were included. Evidence was heterogeneous, but results of the meta-analysis demonstrated a statistically significant difference in overall survival and progression-free survival, in favor of patients treated with durvalumab + gemcitabine\/cisplatin.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This systematic review and meta-analysis confirm durvalumab + gemcitabine\/cisplatin as the best currently available treatment option in patients with advanced biliary tract cancer. Furthermore, multiple real-world cohorts reported similar results even in patients with higher risk factors. However, trials are heterogeneous, and further evidence from real-world cohorts is needed to enhance data quality.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/oncolo\/oyaf224","type":"journal-article","created":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T18:34:54Z","timestamp":1753295694000},"source":"Crossref","is-referenced-by-count":0,"title":["Exploring the impact of first-line durvalumab plus chemotherapy on advanced biliary tract cancer: a systematic review and meta-analysis"],"prefix":"10.1093","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8387-3357","authenticated-orcid":false,"given":"Patrick","family":"Reimann","sequence":"first","affiliation":[{"name":"Department of Internal Medicine II, Academic Teaching Hospital Feldkirch , Feldkirch 6800,","place":["Austria"]},{"name":"Department of Medical Sciences,Private University of the Principality of Liechtenstein , Triesen 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