185 - First-Line Therapy Using Yttrium-90 Radioembolization Plus Systemic Gemcitabine, Cisplatin, and Capecitabine for Unresectable Intrahepatic Cholangiocarcinoma

Monday, April 13, 2026

4:03 PM - 4:12 PM ET

Presenting Author(s)

Qian Yu, MD (he/him/his)

Resident
University of Chicago, United States

Author/Co-author(s)

WL

Wesley Lim, MD

Interventional Radiology Resident
University of Chicago Medical Center, United States
JW

Jonathan Wang, MD

Resident Physician
University of Chicago, United States
TV

Thuong Van Ha, MD

Professor
University of Chicago, United States
MP

Mikin Patel, MD

Assistant Professor
University of Chicago, United States
AP

Anjana Pillai, MD

Professor
University of Chicago, United States
AL

Andy Liao, MD

Professor
The University of Chicago Medicine, United States
JF

John Fung, MD PhD

Professor
University of Chicago, United States
Talia B. Baker, MD (she/her/hers)

Chief of the Division of Transplantation and Advanced Hepatobiliary Surgery
University of Utah, United States
Osman Ahmed, MD, FSIR

Professor of Radiology
University of Utah, United States

Purpose: To evaluate the long-term outcomes of first-line treatment using a combination of yttrium-90 transarterial radioembolization (TARE) and systemic gemcitabine, cisplatin, and capecitabine in patients with unresectable, locally advanced intrahepatic cholangiocarcinoma (iCCA).

Materials and Methods: This single-center retrospective study included treatment-naïve patients with locally advanced iCCA who underwent an institutional downstaging protocol using gemcitabine, cisplatin, TARE, and capecitabine between March 2018 and August 2023. Outcomes assessed included overall survival (OS), radiologic response per RECIST criteria, and treatment-related adverse events.

Results: Twenty-nine patients (17 female, 12 male; mean age 64.8 ± 11.5 years) were included, with a mean dominant tumor size of 6.0 ± 2.4 cm. Radiologic response was observed in 14 of 29 patients (48.3%), while disease control was achieved in 24 of 29 patients (82.8%). From the start of treatment, median OS was 20.3 months (95% CI, 14.7–35.8 months). The 1-year, 3-year, and 5-year OS rates were 82.1% (95% CI, 62.3%–92.2%), 31.4% (95% CI, 15.4%–48.8%), and 18.9% (95% CI, 6.6%–35.9%), respectively. Eight patients (27.6%) were successfully downstaged to surgical resection and demonstrated significantly improved survival (median OS: 60.9 months [95% CI, 24.7–not reached] vs. 15.0 months [95% CI, 11.8–27.7]; p = 0.0001).

Conclusion: The combination of TARE with systemic gemcitabine, cisplatin, and capecitabine demonstrated promising efficacy as a first-line treatment strategy for locally advanced iCCA, with the potential to downstage patients to resection and improve overall survival.