Five patients (16.7%) received a third line of treatment: FOLFIRI regimen ( em n /em =1), FOLFOX regimen ( em n /em =1), GEMOX regimen ( em n /em =1), sorafenib ( em n /em =1), and sunitinib ( em n /em =1). Efficacy Tumour response RECIST assessment was performed Mouse monoclonal to CCND1 in 28 patients (93.3%) with measurable disease. ?30? em /em mol?l?1 ( em P /em =0.001) and positive serology for HBV and/or HCV ( em P /em =0.014) were independent poor prognostic factors for OS. Conclusions: Gemcitabine plus platinum-based chemotherapy is effective as first-line for advanced cHCC-ICC. strong class=”kwd-title” Keywords: hepatocholangiocarcinoma, chemotherapy, prognostic factors Hepatocholangiocarcinoma (cHCC-ICC) is a rare primary hepatic tumour with both, hepatocellular carcinoma (HCC) and cholangiocarcinoma (ICC) histological, features. Its first histological classification dates from 1949 by Allen and Lisa (Allen and Lisa, 1949) and it is now described in the 2010 WHO classification (Theise em et al /em , 2010). The oncogenesis of this tumour remains unclear with hypotheses of the existence of progenitors capable of double differentiation or dedifferentiation of matures hepatocytes (Kim em et al /em , 2004). Moreover, in murine models, existence of several intra-hepatic cell clones with differential potential into hepatocyte and biliary differentiation at the origin of mixed tumours has been described (Piscaglia em et al /em , 2009). The prevalence of cHCC-ICC varies from 1 to 5% of primary liver cancer in Asia and Western countries in different surgical series (Lee em et al /em , 2006; Wachtel em et al /em , 2008; Bergquist em et al /em , 2016). This tumour is more frequent in males, and it is sometimes associated with chronic viral hepatitis B and C, especially in Asian countries. Cirrhosis is associated in 30% of cases (Lee em et al /em , 2006; Chok em et al /em , 2009; Bergquist em et al /em , 2016). About 30% of cHCC-ICC are diagnosed at an advanced stage with synchronous metastases (Wachtel em et al /em , 2008; Wang em et al /em , 2010; Bergquist em et al /em , 2016). The diagnosis may be difficult, and may be based on the analysis of surgical resection specimen or liver biopsy. However, the mixed feature of cHCC-ICC can be misdiagnosed by a biopsy with the identification of the HCC or the ICC histological component only (Tagushi em et FG-4592 (Roxadustat) al /em , 1996). Some typical cHCC-ICC radiological images have been described on contrast enhanced computerised tomography scan (CT-scan) and magnetic resonance imaging, combining, both, arterial phase enhancement/portal venous washout typical of HCC and progressive fibrous stroma central enhancement typical of ICC. Elevation of tumour serum markers can suggest the diagnosis of HCC or ICC, namely, alpha-fetoprotein ( em /em FP) for HCC, and carbohydrate antigen 19C9 (CA 19C9) and carcinoembryonic antigen for ICC. The combination of typical imaging of either HCC or ICC with the elevation of serum tumour markers suggesting the alternative tumour can also help to identify cHCC-ICC (Jarnagin em et al /em , 2002; Tang em et al /em , 2006; Maximin em et al /em , 2014; Li em et al /em , 2016). There has FG-4592 (Roxadustat) been no randomised trial investigating the specific management of cHCC-ICC. Few studies have reported the clinical outcomes after resection, liver transplantation, or transarterial chemoembolization (TACE) for localised cHCC-ICC (Tagushi em et al /em , 1996; Lee em et al /em , 2006; Kim FG-4592 (Roxadustat) em et al /em , 2010; Panjala em et al /em , 2010; Wang em et al /em , 2010; Sapisochin em et al /em , 2011; Groeschl em et al /em , 2013; Park em et al /em , 2013; Garancini em et al /em , 2014; Vilchez em et al /em , 2016). Concerning advanced tumours, Sorafenib is the standard of care for HCC with median overall survival (OS) ranging from 6.5 to 10.7 months (Llovet em et al /em , 2008; Cheng em et al /em , 2009), whereas the combination of gemcitabine and platinum (cisplatin or oxaliplatin) is the standard first-line chemotherapy for ICC with median OS of 11.7 months with GEMCIS regimen in the ABC-02 trial (Valle em et al /em , 2010). Few data regarding gemcitabine and platinum-based.