Олигопрогрессия при холангиокarcinomе продлевает жизнь: результаты реального исследования

Oligo-progression is the leading pattern of treatment failure in advanced cholangiocarcinoma (CCA) treated with immune checkpoint inhibitors (ICIs) and is associated with longer overall survival, according to a real-world study published in Digestive and Liver Disease. While the anatomical patterns of relapse are well-characterized in malignancies like non-small cell lung cancer, they remain poorly mapped in CCA. Identifying localized progression confined to a limited number of lesions—known as oligo-progression—is clinically significant, as this state carries a more favorable prognosis and may benefit from local consolidative therapies. To evaluate these progression patterns, investigators reviewed the records of 131 adults with confirmed unresectable, recurrent, or metastatic CCA treated at 2 tertiary cancer centers in China between September 2019 and September 2024. All participants received ICIs either as monotherapy or in combination regimens. Tumor response was graded using Response Evaluation Criteria in Solid Tumors version 1.1, with oligo-progression defined as disease growth restricted to no more than 5 lesions across a maximum of 3 organs. Survival outcomes were estimated using Kaplan-Meier methods, and independent prognostic factors were identified via Cox regression analysis. Across the entire cohort, median overall survival reached 14.1 months, and median progression-free survival was 7.9 months. Disease progression occurred in 80 patients (61.1%), with 77.5% of these events taking place within the first year of treatment. Oligo-progression accounted for 53.8% of all progression events, while systemic progression accounted for 46.2%. The liver was the most common site of progression (43.8%), followed by abdominal or retroperitoneal lymph nodes (38.8%). Patients experiencing oligo-progression achieved a median overall survival of 22.7 months, compared with 11.7 months for those with systemic progression. Within the oligo-progression group, adding local therapy to systemic treatment demonstrated a survival advantage over systemic therapy alone (28.9 vs 15.8 months), though this difference did not reach statistical significance. Additionally, a baseline carbohydrate antigen 19-9 level of 35 U/mL or higher was independently associated with shorter progression-free and overall survival. “These findings underscore the necessity of multidisciplinary management in CCA and provide a framework for prospective trials evaluating local therapy integration in the immunotherapy era,” the authors concluded. This article originally appeared on Rare Disease Advisor References: Li Y, Mu Y, Li F, et al. Patterns of progression and efficacy of immune checkpoint inhibitors in unresectable, recurrent, or metastatic cholangiocarcinoma: a real-world study. Dig Liver Dis. Published online July 31, 2026. doi:10.1016/j.dld.2026.07.013