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Peterson, Nicole

0009-0000-6035-4124

Mayo Clinic

Division of Hematology and Oncology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI.

Citations 1

Long-Term Outcomes and Surgical Conversion After Immunotherapy in Microsatellite Instability-H Biliary Tract Cancers
Shah, Priyanshi , Peersen, Anina, Sahai, Vaibhav , Mahipal, Amit , Naleid, Nikolas , Borad, Mitesh J. , Bekaii‐Saab, Tanios , Sonbol, Mohamad Bassam , Majeed, Umair , Babiker, Hani M. , O’Donnell, Conor, Malla, Midhun , Conboy, Caitlin B. , Fonkoua, Lionel Kankeu, Washburn, L. , Peterson, Nicole , Carr, Ryan M., Starlinger, P, Smoot, Rory, Warner, Susanne, Ilyas, Sumera L., Heimbach, Julie, Borad, Mitesh J , O'Donnell, Conor D J , Conboy, Caitlin B , Washburn, Leslie A , Halfdanarson, Thorvardur R , Peterson, Nicole , McWilliams, Robert R , Graham, Rondell P , Gores, Gregory J. , Roberts, Lewis R , Ou, Fang-Shu , Tran, Nguyen , Mahipal, Amit , Sonbol, Mohamad B , Bekaii-Saab, Tanios S , Babiker, Hani , Majeed, Umair , Sahai, Vaibhav , Peersen, Anina, Gupta, Garima , Fonkoua, Lionel Aurelien Kankeu , Hálfdánarson, Þorvarður R. , McWilliams, Robert R. , Carr, Ryan M , Graham, Rondell P. , Starlinger, Patrick, Warner, Susanne, Ilyas, Sumera I. , Gores, Gregory J. , Roberts, Lewis R. , Heimbach, Julie K. , Ou, Fang‐Shu , Tran, Nguyen H.

JCO Precision Oncology | July 10, 2026 | Volume: 10 | Issue: 7 | Pages: No page available

10.1200/po-25-01156 Get It

PURPOSE Deficient mismatch repair/microsatellite instability (dMMR, MSI-H) in biliary tract cancers (BTCs) is observed in 1%-5% of tumors. MSI-H across solid tumors has demonstrated durable response to immune checkpoint inhibitors (ICIs) regardless of the anatomic location. Here, we describe clinical outcomes and surgical conversion of MSI-H BTC treated with ICIs. Patients and Methods We conducted a multicenter, retrospective analysis of BTC patients with dMMR/MSI-H between 2017 and 2024 at Mayo Clinic, University of Michigan, and University Hospitals Seidman Cancer Center. Outcomes of interest were surgical resection rate, rate of pathologic response, 2-year overall survival (OS; time from initiation of treatment to death/last follow-up), and time to treatment discontinuation (TTD; time from initiation of treatment to cessation because of any cause). Analyses were descriptive. RESULTS Thirty patients with MSI-H BTC were identified: 19 with cholangiocarcinoma, three with gallbladder cancer, and 8 with BTC undefined. The median age at diagnosis was 61.5 years (range, 26-86). Twenty-six (86.7%) patients had advanced stage at diagnosis. Twenty-seven patients (90%) received first-line systemic therapy, and 13 (48.1%) continued onto second line. Six patients (23.1%) were restaged to resectable from advanced disease after ICI therapy and underwent resection; all remained recurrence-free at last follow-up. Of these six patients, 3 (50%) achieved a pathologic complete response. Among those receiving first-line therapy, the median TTD was 9.9 months (95% CI, 5.7 to 14.5 months) and the 2-year OS was 73% (95% CI, 56% to 94%). CONCLUSION ICI therapy in patients with MSI-H BTC demonstrated durable response and downstaged some BTC to a resectable stage. dMMR/MSI-H should be performed up-front to guide treatment decisions.