# ACTICCA-1: HCP commentary report

> 79 verified statements (42 from clinicians verified by NPI or staff page) from 29 commentary sources · 7 findings · updated Nov 1, 2026

## Report

- Trial: Adjuvant Chemotherapy With Gemcitabine and Cisplatin Compared to Standard of Care After Curative Intent Resection of Cholangiocarcinoma and Muscle Invasive Gall Bladder Carcinoma (ACTICCA-1 Trial)
- NCT ID: NCT02170090
- Registry: https://clinicaltrials.gov/study/NCT02170090
- Sponsor: Universitätsklinikum Hamburg-Eppendorf
- Phase: Phase 3
- Status: Active, not recruiting
- Drugs tested: gemcitabine plus cisplatin
- Indication: biliary tract cancer after curative intent resection
- Version: v1.0.0, edition 1
- Accepted: 2026-11-01
- Last checked: 2026-11-01
- Release hash: 29599d8c0cea4b5a63a668ef2c7aab3f9bd8fcff29c199522a7653a12feab0a0

## Counts

- HCP commentary sources screened: 65
- Sources cited by verified statements: 31
- Verified statements: 79
- From speakers with a confirmed clinical role (verified by the NPI registry or their own institution's staff page): 42
- Findings: 7
- Named people in screened sources (unnamed speakers and accounts not counted): 27
- Voices cited: 27
- Cited voices identity-verified: 24
- Organisational or shared accounts (not counted as people): 1

Counts describe the retained sources. They do not estimate how many HCPs hold a view.

## Abstract

ACTICCA-1 asks whether adjuvant gemcitabine–cisplatin improves disease-free survival over standard care after curative-intent resection of cholangiocarcinoma or muscle-invasive gallbladder cancer; debate concerns selective GemCis use rather than routine replacement. The report cites 13 physicians, including five medical oncologists, six surgical oncologists and one radiation oncologist; another question is whether nodal staging changes treatment or informs prognosis. Which patients, if any, justify optional GemCis given reported toxicity and concerns about preserving later treatment? The sources reviewed for this edition place ACTICCA-1 results at ESMO 2026.

## Open Medical Affairs question

What patient profile, if any, justifies optional GemCis when speakers report additional toxicity and worry about preserving later treatment?

Raised by the leading finding. The report shows what clinicians said and the sources behind it; it does not settle the question.

## Findings (titles)

- F1. No routine switch, but selective GemCis remains a contested option
- F2. Early and numerical efficacy signals are not being read as an unequivocally positive primary comparison
- F3. Individualization reflects recovery and tolerability, not a validated escalation rule
- F4. Nodal staging divides treatment-selection arguments from prognostic value
- F5. Locoregional control and chemoradiation have rationales distinct from a survival claim
- F6. Persistent recurrence prompts alternative-strategy questions, not proven replacements
- F7. Evolving comparators and long evidence timelines frame both anticipation and disappointment

## What sits behind each finding

Counts describe what the report retained, not how many clinicians hold a view. A statement can support more than one finding.

| Finding | Statements | Passages | Sources | Named voices | Counterview | Limitations |
| --- | ---: | ---: | ---: | ---: | --- | ---: |
| F1 | 11 | 14 | 14 | 8 | recorded | 3 |
| F2 | 9 | 8 | 7 | 5 | recorded | 3 |
| F3 | 12 | 7 | 5 | 6 | none recorded | 3 |
| F4 | 15 | 15 | 1 | 10 | recorded | 3 |
| F5 | 6 | 7 | 3 | 4 | recorded | 3 |
| F6 | 9 | 9 | 7 | 7 | none recorded | 3 |
| F7 | 18 | 11 | 10 | 11 | none recorded | 3 |

### What the statements are

| Finding | Views | Questions and uncertainty | Clinical experience | Comparisons | Restated results and context | Passages supporting | Passages giving context | Sources by kind | Feeds the Medical Affairs question |
| --- | ---: | ---: | ---: | ---: | ---: | ---: | ---: | --- | --- |
| F1 | 11 | 0 | 0 | 0 | 0 | 14 | 0 | 14 posts and articles | yes |
| F2 | 5 | 1 | 0 | 0 | 3 | 10 | 0 | 6 posts and articles, 1 podcast or video | yes |
| F3 | 7 | 2 | 0 | 2 | 1 | 13 | 0 | 4 posts and articles, 1 podcast or video | yes |
| F4 | 9 | 3 | 2 | 1 | 0 | 15 | 1 | 1 post or article | yes |
| F5 | 2 | 1 | 2 | 0 | 1 | 6 | 1 | 2 posts and articles, 1 podcast or video | yes |
| F6 | 6 | 3 | 0 | 0 | 0 | 9 | 1 | 5 posts and articles, 2 podcasts and video | yes |
| F7 | 7 | 4 | 0 | 2 | 5 | 18 | 0 | 9 posts and articles, 1 podcast or video | yes |

### Trial dimensions

- Primary endpoint: Disease free survival (DFS): F2 (7 shared claims), F3 (1 shared claims)
- Secondary endpoints: F1 (6 shared claims), F2 (6 shared claims), F3 (3 shared claims), F5 (3 shared claims), F6 (2 shared claims)
- Population and setting: F2 (3 shared claims), F3 (6 shared claims), F4 (2 shared claims), F5 (2 shared claims), F7 (1 shared claims)
- The comparison: F1 (11 shared claims), F2 (4 shared claims), F3 (5 shared claims), F4 (1 shared claims), F5 (2 shared claims), F6 (3 shared claims), F7 (11 shared claims)
- Safety and tolerability: F1 (2 shared claims), F2 (2 shared claims), F3 (5 shared claims), F6 (1 shared claims)
- Design and conduct: F2 (1 shared claims), F7 (11 shared claims)

## Sample findings

Paraphrased; the full report links each statement to its source.

### F7. Evolving comparators and long evidence timelines frame both anticipation and disappointment

A surgical oncologist in a podcast discussion raised a design question about whether ACTICCA-1’s switch from observation to capecitabine could affect statistical power.

Source: podcast, 2024-04-25.

### F3. Individualization reflects recovery and tolerability, not a validated escalation rule

A podcast discussion asked how adjuvant evidence applies to resected perihilar cholangiocarcinoma and whether trial data could clarify treatment beyond capecitabine alone.

The clinical role of the speaker asking about perihilar cholangiocarcinoma is not confirmed in the sources reviewed for this edition.

Source: podcast, 2024-04-25.

## What's inside

| Section | Items | Access |
| --- | ---: | --- |
| Findings with interpretation, counterviews and limits | 7 | Titles free |
| Detailed analysis | 8 sections | Paid |
| Verified statements with short source quotes and links | 79 | Paid |
| Trial aspects mapped | 12 | Free |
| Sources with links | 31 | Counts free |
| Speaker attribution for cited voices | 27 | Paid |

## Trial aspects

12 discussed · 0 no commentary found · 0 assessment incomplete.

| Aspect | Coverage | Statements | Sources |
| --- | --- | ---: | ---: |
| Primary endpoint: Disease free survival (DFS) | discussed | 7 | 6 |
| Secondary endpoints | discussed | 15 | 14 |
| Population and setting | discussed | 14 | 8 |
| The comparison | discussed | 32 | 26 |
| Safety and tolerability | discussed | 5 | 4 |
| Design and conduct | discussed | 12 | 5 |
| Preserving GemCis for treatment after recurrence | discussed | 2 | 2 |
| Individualized adjuvant goals and selective escalation | discussed | 15 | 9 |
| Nodal work-up, treatment consequences and patient counseling | discussed | 16 | 2 |
| Local versus systemic control and chemoradiation alternatives | discussed | 6 | 3 |
| Alternative strategies: selection, added agents and perioperative sequencing | discussed | 11 | 7 |
| Confidence in existing adjuvant evidence and expectations for ACTICCA-1 | discussed | 13 | 10 |

An aspect marked incomplete is a question the public commentary did not let us answer. We show it rather than hide it.

## Sources

| Channel | Screened | Cited |
| --- | ---: | ---: |
| X threads | 59 | 26 |
| Bluesky threads | 3 | 0 |
| LinkedIn posts | 1 | 1 |
| Podcasts | 1 | 1 |
| X videos | 1 | 1 |
| Publications (primary source, cited for context) | not screened | 1 |
| Registry (primary source, cited for context) | not screened | 1 |

- Screened window: 2017-01-20 to 2026-10-30
- Cited window: 2017-01-20 to 2026-10-26
- Retrieved: 2026-11-01

Screened sources were retrieved for this trial. Cited sources back at least one verified statement and include primary sources used for context.

## The trial

From ClinicalTrials.gov.

- Title: Adjuvant Chemotherapy With Gemcitabine and Cisplatin Compared to Standard of Care After Curative Intent Resection of Cholangiocarcinoma and Muscle Invasive Gall Bladder Carcinoma (ACTICCA-1 Trial)
- Registry: NCT02170090 (https://clinicaltrials.gov/study/NCT02170090)
- Study IDs: ACTICCA-1 · 2024-517340-61-00 · ACTRN12615001283561 (ANZCTR (clinical trial registry))
- Sponsor: Universitätsklinikum Hamburg-Eppendorf
- Collaborators: Deutsche Krebshilfe e.V., Bonn (Germany), Cancer Research UK, Australasian Gastro-Intestinal Trials Group, Dutch Cancer Society
- Design: Phase 3 · interventional, randomized, parallel, phase3
- Status: Active, not recruiting
- Enrollment: 789 (actual)
- Start: 2014-04
- Primary completion: 2025-12 (estimated)
- Primary endpoint: Disease free survival (DFS) (Disease free survival rate at 24 months (DFSR@24))
- Intervention: Gemcitabine (drug)
- Intervention: Cisplatin (drug)
- Intervention: Capecitabine (drug)

## Scope and limits

This report does not judge efficacy, estimate HCP prevalence or consensus or give treatment advice.

- Discussion that does not name the trial may be missing from this edition.
- Some passages in the sources used in this report were not fully assessed for clinician views, so a view there may be missing from this edition.
- 81 statements in the sources reviewed for this edition are about other patients or topics, or only mention the trial, and are not counted.
- Further source limits: discussion that describes the trial without naming it may be incomplete; some discussion that describes the trial without naming it may be missing; sources about other trials are not included.
- The sources reviewed for this edition do not represent all HCP discussion or establish the prevalence of any treatment preference.
- Some passages were not fully assessed for clinician views. Discussion using unnamed references or other trial-name variants may be missing, including within sources considered for this edition.
- Repeated posts and reposts must not be interpreted as additional independent HCP opinions or as evidence of agreement.
- Some speakers' identities or clinical roles are not established in the sources used in this report; each statement is attributed only as far as its source shows.
- The primary publications provided here describe methods rather than observed results. Efficacy and toxicity figures in the report are attributed commentary, not an independently reconciled trial-results dataset.
- Different median DFS values and OS p-values appear in the summaries, without enough information to explain whether they concern different analyses or populations.
- Historical statements about standards, trial status and expected reporting retain their original timing. They do not establish actual reporting dates or changes in a speaker's position.
- No assessed commentary addresses quality of life, biliary anastomotic function or biliary infection outcomes.

How reports are built and checked: https://www.erudio.com/methods

## Editions and corrections

- v1.0.0, accepted 2026-11-01: current edition

Last checked for new commentary 2026-11-01. No corrections. Versions follow semver: a new or changed finding is a minor version, more evidence without a material change is a patch.

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## Cite

Erudio Health. ACTICCA-1 (NCT02170090): HCP commentary report. Edition 1, v1.0.0. Accepted Nov 1, 2026. https://www.erudio.com/reports/acticca-1-nct02170090

## Machine access

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