Based on the TOPAZ-1 study, do you now routinely include durvalumab in first line treatment of advanced bile duct cancer?

YES! And it is a strong yes. TOPAZ-1 is a very elaborate study with statistically and clinically significant data outcomes. See Do et al., Journal of Clinical Oncology 2022. What is better than holding chemotherapy after 6 months and keeping patients on single agent durvalumab? And avoiding all cumu...

**I deleted the initial part of my answer to this question, as the TOPAZ-1 regimen has now been FDA-approved for treatment of metastatic biliary tract cancer.**

It is notable also that much of the separation of survival curves in TOPAZ-1 happened after cessation of active therapy in the control grou...

The TOPAZ-1 study showed that the combination of durvalumab plus gemcitabine/cisplatin prolonged overall survival over gemcitabine/cisplatin alone in advanced biliary tract cancer, and was also well tolerated. Although the survival benefit of durvalumab in this setting is modest, I do think the data...