First-Line Chemotherapy and Durvalumab in Advanced BTC: Oncology Advances — March 2026

Patients with advanced biliary tract cancer (BTC) often have limited life expectancy, making quality of life and time spent receiving medical care (“time toxicity”) important considerations when selecting systemic therapy. This multicenter retrospective study evaluated whether adding durvalumab to gemcitabine–cisplatin (GCD) increases healthcare-related time burden compared with gemcitabine–cisplatin alone (GC).

The study included 193 patients treated between 2019 and 2024 across centres in the United States, Japan, and Brazil. Among them, 102 received GCD and 91 received GC. The median time on treatment was 156 days, and the median proportion of time spent in healthcare systems was 14.4%. Most healthcare contacts consisted of planned visits (11.9%), while unplanned visits were uncommon (1.8%).

Although patients receiving GCD remained on treatment longer than those receiving GC (212 vs 134 days), the overall time to toxicity was similar between groups (27 vs 18 days). Time toxicity strongly correlated with treatment duration and progression-free survival, indicating that longer treatment exposure naturally increases healthcare contact time.

Multivariable analysis showed that younger patients and those with poorer performance status experienced higher time toxicity.

Overall, the study highlights time toxicity as an important patient-centred metric in advanced cancer care. The addition of durvalumab to gemcitabine–cisplatin prolongs treatment duration without increasing the proportion of time spent receiving healthcare, providing useful information for shared decision-making between clinicians and patients when balancing survival benefits and quality of life.