Real-World Treatment Patterns and Early Outcomes in Advanced Intrahepatic Cholangiocarcinoma: A Descriptive Case Series

Cancer research · Cholangiocarcinoma

This study describes that lenvatinib + immune checkpoint inhibitors combined with early trans‑arterial interventional therapies may be a feasible multimodal strategy used in real‑world practice for advanced intrahepatic cholangiocarcinoma, with preliminary observations of feasibility.

A retrospective, single-center case series of 12 patients with advanced intrahepatic cholangiocarcinoma (ICC) describes real‑world clinical characteristics, treatment patterns, early tumor response and safety outcomes. Patients received lenvatinib‑based targeted‑immunotherapy with or without trans‑arterial interventional therapies (TAIT), or conventional chemotherapy. Objective response rate was 33.3 % and disease‑control rate 83.3 %. Grade ≥ 3 treatment‑related adverse events occurred in 22.2 % of patients treated with lenvatinib + PD‑1/PD‑L1 inhibitors and in 66.7 % of patients treated with chemotherapy. Early TAIT (≤ 2 weeks after systemic therapy initiation) was associated with higher mean tumor‑reduction rate (30.5 % vs. 7.7 %). The study highlights the feasibility of a multimodal strategy in real‑world practice but is limited by its small, single‑center design and short follow‑up.

Most evidence for advanced ICC comes from clinical trials that may not reflect the heterogeneity and treatment barriers seen in routine practice. This real‑world case series provides early efficacy and safety data for a multimodal regimen that could be adopted for patients ineligible for standard gemcitabine‑plus‑cisplatin plus durvalumab, addressing an unmet clinical need and generating hypotheses for future prospective studies.

Evidence level: Korai humán adat. Kis vagy feltáró emberi adat.

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