A recap of the AGITG Preceptorship in Biliary Tract Cancer and Hepatocellular Carcinoma

Thank you to Dr Deborah Zhou and Dr Joanna Lee for their contributions to this article.

Another successful AGITG Preceptorship was held on 25–26 August, at the beautiful Crowne Plaza Sydney, Coogee Beach, this time focussed on biliary tract cancer and hepatocellular carcinoma (HCC). The 2023 Preceptorship was convened by medical oncologists Associate Professor Lara Lipton and Associate Professor Amitesh Roy.

This year’s AGITG Preceptorship was a valuable educational event given the rarity of these cancers. Surgery, gastroenterology, radiation and medical oncology were all represented by our expert preceptors, who provided invaluable discussion and insights. The background of the preceptees was just as diverse, with colleagues from New Zealand and the UK in attendance, as well as attendees from all over Australia.

The sessions were divided by stage of disease, from early to late stage, and there was fantastic multidisciplinary discussion regarding the diagnosis and management of biliary tract cancer and HCC.

There was a variety of studies presented: single centre retrospective cases, phase II trials, double blinded randomised controlled trials and systematic reviews and meta-analyses. All the preceptors conducted high-level analysis of these studies considering multiple factors such as statistical analysis, impact of bias and unknown confounders and discussed whether this was relevant to our patient population and current practice.

The session on biomarker-directed therapies in advanced biliary cancers highlighted new drugs which can target certain molecular alterations such as IHD and FGRF mutations which is very exciting in the space. However, the group also discussed problems such as difficulties in identifying these alterations, with accessing drugs, and cost. As a group, we talked about the importance of obtaining tumour tissue to test for any targetable molecular alterations using next-generation sequencing to identify treatments for our patients and to further advance translational research.

The HCC multidisciplinary case generated excellent discussion about the role of liver transplantation, which patients are eligible and what factors needed to be considered. There was also discussion about how best to utilise local therapies such as SBRT or TACE in setting of advanced stage HCC.

A special mention is deserved for guest speaker Richard De Abreu Lourenco from CREST, who provided an engaging crash course on health economics with an oncology research spin. We learned about the different types of economic evaluation and how these are incorporated into the process of funding drugs or devices in Australia and New Zealand. The talk was very informative as this type of teaching is not typically embedded in medical school or during training.


Thank you to AstraZeneca for your exclusive sponsorship of this year’s Preceptorship.

You can learn more about AstraZeneca’s Imfinzi (durvalumab) biliary tract cancer patient access program here.

 


Thank you to all participants, Convenors and Preceptors

  • Associate Professor Lara Lipton, medical oncology
  • Associate Professor Amitesh Roy, medical oncology
  • Professor Lorraine Chantrill, medical oncology
  • Dr Connie Diakos, medical oncology
  • Dr Daniel Croagh, surgery
  • Associate Professor Charles Pilgrim, surgery
  • Dr Julie Chu, radiation oncology
  • Dr Andrew Oar, radiation oncology
  • Dr Jessica Yang, radiology
  • Associate Professor John Lubel, gastroenterology
  • Dr Joanna Lee
  • Dr Sarah Maloney
  • Dr Derrick Siu
  • Dr Deborah Zhou
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