{"id":"doi:10.1016/j.esmorw.2026.100783","kind":"article","title":"Real-world survival benefit of adding durvalumab to chemotherapy in cholangiocarcinoma: a retrospective cohort analysis from a German Comprehensive Cancer Centre","authors":["Elbasan S","Kasper S","Mavroeidi IA","Kostbade K","Siveke J","Spelsberg L","Majorczyk S","Neuhaus A","Akbari S","Wiesweg M","Baba H","Hartmann S","Schmidt H","Neumann U","Albers D","Markus P","Schuler M","Virchow I"],"author_count":18,"year":2026,"published":"2026-09-21","venue":"ESMO real world data and digital oncology","cited_by":0,"doi":"10.1016/j.esmorw.2026.100783","arxiv_id":null,"nct_id":null,"source_url":"https://doi.org/10.1016/j.esmorw.2026.100783","archive_url":"https://space-kitty.com/papers/doi:10.1016/j.esmorw.2026.100783","updated":null,"pmid":"42828095","pmcid":"PMC13631604","openalex_id":null,"pdf_url":"https://europepmc.org/articles/PMC13631604/pdf","abstract":"Background Advanced biliary tract cancers (BTCs) carry a poor prognosis. Gemcitabine/platinum chemotherapy was the first-line standard until TOPAZ-1 and KEYNOTE-966 established immune checkpoint inhibitor-based combinations as a new standard. Real-world data with a chemotherapy-only comparator remain limited. Patients and methods We retrospectively analyzed 172 patients with advanced BTC treated at the West German Cancer Centre (2018-2024): a durvalumab cohort ( n = 64, treated 2022-2024) and a historical comparator cohort ( n = 108, chemotherapy alone). Because cohort assignment was based on treatment era rather than randomization, propensity score matching (incorporating age, sex, metastatic burden, CA19-9, tumor location, and chemotherapy regimen) was carried out; analyses are reported for both the unmatched ( n = 172) and matched ( n = 77) cohorts. The primary endpoint was median overall survival (mOS); secondary endpoints included objective response rate (ORR), disease control rate (DCR), time to treatment failure (TTF), and toxicity. Results In the matched cohort ( n = 77), durvalumab was associated with significantly longer mOS (14.6 versus 11.1 months; hazard ratio 0.54, 95% confidence interval 0.307-0.956, P = 0.032) and a higher ORR (45% versus 20%; P = 0.015); DCR was numerically higher (65% versus 47.5%; P = 0.083). In the unmatched cohort ( n = 172), durvalumab was associated with a larger mOS difference (18.7 versus 12.8 months; P = 0.003), higher ORR (42.2% versus 24.1%; P = 0.018) and DCR (65.6% versus 45.4%; P = 0.011); TTF trended in favor of durvalumab (4.8 versus 3.4 months; P = 0.066). No new safety signals were observed. Conclusions These real-world data support the clinical benefit of adding durvalumab to gemcitabine/platinum chemotherapy in patients with advanced BTC, consistent with TOPAZ-1 and KEYNOTE-966. Given the retrospective design, findings should be regarded as supportive of, rather than exceeding, pivotal trial data.","abstract_license":"CC-BY (article license as recorded by Europe PMC; abstract reproduced unmodified apart from markup removal)","license":"CC-BY","is_open_access":true,"retracted":false,"peer_reviewed":null,"categories":[],"details":null,"provenance":"europepmc","attribution":"Abstract of \"Real-world survival benefit of adding durvalumab to chemotherapy in cholangiocarcinoma: a retrospective cohort analysis from a German Comprehensive Cancer Centre\" by Elbasan S, Kasper S, Mavroeidi IA et al., https://doi.org/10.1016/j.esmorw.2026.100783, used under its Creative Commons Attribution license (CC-BY); markup removed, otherwise unmodified.","topics":[{"slug":"cancer-immunotherapy","name":"Cancer Immunotherapy","domain_slug":"medicine"}],"cited_in_dossiers":[{"slug":"cancer-immunotherapy","title":"Cancer Immunotherapy: State of the Field (October 2026)","url":"https://space-kitty.com/dossiers/cancer-immunotherapy"}]}