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Standard chemotherapy agents for advanced biliary cancer are gemcitabine and cisplatin. Recent data suggest a modest benefit for use of second-line FOLFOX. Interest in three-drug regimens has been supported in pancreaticobiliary cancers based on use of first line FOLFIRINOX in pancreatic cancer.
Investigators now report results of the PRODIGE 38 AMEBICA study, an open-label, multicenter, phase 2/3 trial comparing first-line treatment of advanced biliary cancer with modified FOLFIRINOX or gemcitabine-cisplatin. Of 190 patients randomized, most had intrahepatic primaries (62%–64%) followed by extrahepatic (19%–21%) and gallbladder (17%–18%). A minority had prior surgery (17%–25%) and most had liver or liver plus extrahepatic disease (71%–85%).…