Survival after targeted chemotherapy and unresectable biliary malignancies (systematic review and meta-analysis)

Aim . To evaluate the survival rate of patients with unresectable biliary malignancies under targeted chemotherapy in order to identify the most promising adjuvant regimens. Materials and methods. The study involves publications in PubMed Central, RSCI, and Cochrane databases. Heterogeneity was assessed graphically (blobograms) and statistically (τ 2 and I2 ). Results . Meta-analysis of five-year survival revealed a greater pooled estimate of the period in the main groups treated with targeted chemotherapy – 295 ± 71 days (95% CI 144–408; p <0.001) against comparison groups – 205 ± 81 days (95% CI 81–426; p <0.001). Study heterogeneity was considered moderate (I2 = 0%, p = 0.06). No significant publication errors and biases were revealed in both meta-analyses. Conclusion . Targeted chemotherapy increases the overall survival of patients with unresectable malignancies of the bile ducts. Systemic chemotherapy based on gemcitabine and cisplatin with addition of ivosidenib, a selective inhibitor of mutant IDH1, showed the best efficacy.