Can durvalumab incorporation to gem+cis for advanced BTCs allow for earlier discontinuation of cytotoxic chemotherapy in patients exhibiting response?

The TOPAZ-1 study was double blinded, and there were no meaningful differences in gemcitabine/cisplatin treatment duration between the groups. I do not intend to give fewer cycles of gemcitabine/cisplatin now that durvalumab has been added to the armamentarium. In the past, I would usually discuss m...

I think the opposite question is more relevant: should we extend chemo beyond just 8 cycles, or limit it to 8 as in the TOPAZ-1 trial? Would the trial still have been positive if chemo wasn't stopped at 8 cycles? Many patients can tolerate longer than this, especially gemcitabine. In fact, the KEYNO...

The data right now does not support shortening chemo duration.

We are never likely to have level 1 evidence to answer this question. Cholangioca is too rare. However we have done many trials on stop-and-go, maintenance therapy or treatment breaks in colon cancer showing these make little difference in OS. Personally, for patients with CPS > 10, I will be very c...