Patient Characteristics and Treatment Patterns of Advanced Biliary Tract Cancer (BTC): A Chinese Physician Survey

INTRODUCTION: Biliary tract cancers (BTCs) encompass rare malignancies arising from bile duct and gallbladder epithelial cells. This study investigated Chinese physicians' understanding of advanced BTC including patient characteristics, treatment patterns, and decision-making factors in clinical practice. METHODS: A survey of 120 randomly selected physicians who currently treat patients with advanced BTC was conducted between September 19, 2024 and November 4, 2024. RESULTS: Of the 120 total respondents, 48 were surgeons, 48 were oncologists, and 24 were interventionalists or radiotherapists. The respondents indicated that over half of patients (58.2%) are initially deemed to have unresectable tumors. Physicians estimated that 77.3% of patients with advanced BTC receive first-line therapy, most commonly with immunotherapy plus chemotherapy (34.2%), chemotherapy alone (15.8%), or local-regional combination therapies (10.8%). The most commonly used immunotherapy plus chemotherapy regimen is gemcitabine and cisplatin plus immunotherapy followed by gemcitabine plus oxaliplatin plus immunotherapy. Following progression on first-line therapy, physicians indicated 43.8% of patients proceed to subsequent treatment, most commonly with immunotherapy plus chemotherapy (23.3%), chemotherapy (12.5%), or immunotherapy plus anti-angiogenic agent (11.7%). The average physician satisfaction scores for current treatment and management of advanced BTC were between 6.1 and 7.5 out of 10. The key challenges indicated by respondents in treating patients with advanced BTC were limited selection of treatment regimens (46.7%) and financial barriers to care (40.0%). CONCLUSION: This is the first study to report Chinese physicians' understanding of patient characteristics and treatment patterns for advanced BTC, providing valuable insights which will inform advanced BTC treatment in China. TRIAL REGISTRATION: Chinese Clinical Trial Registry identifier, ChiCTR2400087092.