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Tovecimig (CTX-009)

Second-line advanced biliary tract cancer

Also known as ABL001
Last updated
89 sources

Product information and disease descriptionPlace of product in therapyDisease description

Clinical presentation - signs and symptoms

6 evidence topics · 5 sources

Obstructive and biliary symptoms: jaundice from biliary tract obstruction

“CCAs are usually asymptomatic during early stages. The most frequent symptom of pCCA and dCCA is jaundice due to biliary tract obstruction88. In iCCA, jaundice is less frequent and mostly associated with advanced disease.” (opens the source at this quote in a new tab)

“Patients with pCCA and dCCA typically present with painless jaundice owing to underlying biliary obstruction.” (opens the source at this quote in a new tab)

“Intrahepatic disease may manifest as a liver mass or cholangitis with possible intrahepatic abscess formation as well as right upper quadrant pain related to capsular distension, whereas extrahepatic neoplasms lead to painless obstructive jaundice and cholangitis.” (opens the source at this quote in a new tab)

Pruritus and its consequences in malignant biliary obstruction

“In fact, the presence of pruritus can cause severe sleep deprivation resulting in lassitude, fatigue, depression, and suicidal ideation [3]. On the other hand, in patients with better prognosis, biliary obstruction and jaundice also lead to hepatic failure and compromise the administration of chemotherapy, when clinically indicated.” (opens the source at this quote in a new tab)

Pain: abdominal and right upper quadrant pain

“Other symptoms of advanced disease include asthenia, abdominal pain, malaise, nausea, anorexia and weight loss.” (opens the source at this quote in a new tab)

“Gallbladder cancer may be found incidentally at cholecystectomy; however, it may present with pain due to mass effects and may also trigger obstructive jaundice.” (opens the source at this quote in a new tab)

Constitutional symptoms: asthenia, anorexia, nausea, and weight loss

“Patients with iCCA are often asymptomatic during early disease stages and develop symptoms or signs, such as abdominal pain or less commonly jaundice, during disease progression to an advanced stage.” (opens the source at this quote in a new tab)

“There was also a trend towards worsening of nausea and pain in the ASC arm, which remained stable in the ASC + FOLFOX arm.” (opens the source at this quote in a new tab)

Asymptomatic and incidental presentation

“iCCA is an incidental finding in around 20–25% of cases88. In patients with cirrhosis, ultrasonography surveillance for HCC enables iCCA diagnosis at an asymptomatic, early stage89.” (opens the source at this quote in a new tab)

“However, most patients (∼70%) are diagnosed at late stages due to lack of specific symptoms104.” (opens the source at this quote in a new tab)

“iCCA is often seen at presentation as an intrahepatic mass and is incidentally found in 25–30% of patients” (opens the source at this quote in a new tab)

Symptom domains captured by the disease-specific quality-of-life module

“The QLQ-BIL21 consists of 21 questions: 3 single-item assessments relating to treatment side effects, difficulties with drainage bags/tubes and concerns regarding weight loss, in addition to 18 items grouped into 5 proposed scales: eating symptoms (4 items), jaundice symptoms (3 items), tiredness (3 items), pain symptoms (4 items) and anxiety symptoms (4 items).” (opens the source at this quote in a new tab)