Advanced bile duct cancers: A focused review on current and emerging systemic treatments Review
| Authors: | Cowzer, D.; Harding, J. J. |
| Review Title: | Advanced bile duct cancers: A focused review on current and emerging systemic treatments |
| Abstract: | Cancers arising in the biliary tract are rare, with varied incidence depending on geographical location. As clinical presentation is typically vague with non-specific symptoms, a large proportion of patients present with unresectable or metastatic disease at diagnosis. When unresectable, the mainstay of treatment is cytotoxic chemotherapy; however, despite this, 5-year overall survival remains incredibly poor. Diagnostic molecular pathology, using next-generation sequencing, has identified a high prevalence of targetable alterations in bile duct cancers, which is transforming care. Substantial genomic heterogeneity has been identified depending on both the anatomical location and etiology of disease, with certain alterations enriched for subtypes. In addition, immune checkpoint inhibitors with anti-PD-1/PD-L1 antibodies in combination with chemotherapy are now poised to become the standard first-line treatment option in this disease. Here, we describe the established role of cytotoxic chemotherapy, targeted precision treatments and immunotherapy in what is a rapidly evolving treatment paradigm for advanced biliary tract cancer. © 2022 by the authors. Licensee MDPI, Basel, Switzerland. |
| Keywords: | treatment outcome; review; cisplatin; fluorouracil; advanced cancer; cancer combination chemotherapy; patient selection; systemic therapy; drug targeting; gemcitabine; homologous recombination; ipilimumab; ticilimumab; cancer immunotherapy; protein targeting; epidermal growth factor receptor; epidermal growth factor receptor 2; tumor marker; cancer therapy; irinotecan; immunotherapy; cholangiocarcinoma; drug cytotoxicity; oncogene k ras; trastuzumab; oxaliplatin; k ras protein; gallbladder cancer; b raf kinase; biliary tract cancer; fibroblast growth factor; bile duct cancer; pertuzumab; personalized medicine; isocitrate dehydrogenase; molecularly targeted therapy; dabrafenib; trametinib; nivolumab; regorafenib; human; precision medicine; pembrolizumab; receptor tyrosine kinase like orphan receptor; durvalumab; erdafitinib; infigratinib; ivosidenib; pemigatinib; triplet chemotherapy; bintrafusp alfa; derazantinib; futibatinib; zoligratinib; doublet chemotherapy |
| Journal Title: | Cancers |
| Volume: | 14 |
| Issue: | 7 |
| ISSN: | 2072-6694 |
| Publisher: | MDPI |
| Date Published: | 2022-04-01 |
| Start Page: | 1800 |
| Language: | English |
| DOI: | 10.3390/cancers14071800 |
| PROVIDER: | scopus |
| PMCID: | PMC8997852 |
| PUBMED: | 35406572 |
| DOI/URL: | |
| Notes: | Review -- Export Date: 2 May 2022 -- Source: Scopus |
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