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Background

Biliary tract cancers (BTCs) are aggressive malignancies with limited response to chemotherapy and a dismal prognosis. Gemcitabine/cisplatin (GC) was considered the first-line treatment option in advanced disease for many years until the success of two phase 3 trials (TOPAZ-01, KEYNOTE-966). Current guidelines recommend immune checkpoint inhibitors (ICIs) combined with chemotherapy as the standard of care. We aim to compare the efficacy of first-line therapies for advanced BTC.

Methods

Our search focused on English-language articles from MEDLINE, Embase, Scopus, Web of Science, Cochrane Library, published between January 2010 and February 2024. We included full-text randomized clinical trials (RCTs) investigating GC as a treatment arm for treatment-naïve adult patients with advanced BTC. Outcomes measured were overall survival (OS) and progression-free survival (PFS). We …