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This combination treatment regimen, studied in the DELTIC trial (NCT01648023) led by Robert C. Martin II, is designed for the treatment of unresectable intrahepatic cholangiocarcinoma (ICC). The therapy integrates systemic chemotherapy—consisting of gemcitabine paired with a platinum agent (either cisplatin or carboplatin)—with localized transarterial chemoembolization (TACE) using irinotecan-loaded drug-eluting beads (DEBIRI). Gemcitabine acts as a nucleoside analog that inhibits DNA synthesis, while cisplatin and carboplatin are platinum-based agents that cause DNA cross-linking. Irinotecan, a topoisomerase I inhibitor, is delivered directly to liver tumors via drug-eluting beads (such as Oncozene or LC Beads), providing a high local concentration of chemotherapy while minimizing systemic toxicity. This multi-modal approach aims to improve outcomes in patients with advanced biliary tract cancers by providing both systemic control and targeted regional therapy.
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