New Horizons for Precision Medicine in Biliary Tract Cancers

Unfortunately the full text is not available for free, but it’s a good overview of the research and developments thus far. Blessings, Tilly

Valle JW, Lamarca A, Goyal L, Barriuso J, Zhu AX.
New Horizons for Precision Medicine in Biliary Tract Cancers.
Cancer Discov. 2017 Aug 17. doi: 10.1158/2159-8290.CD-17-0245. [Epub ahead of print]
https://www.ncbi.nlm.nih.gov/pubmed/?term=28818953

Biliary tract cancers (BTC), including cholangiocarcinoma and gallbladder cancer,
are poor-prognosis and low-incidence cancers, although the incidence of
intrahepatic cholangiocarcinoma is rising. A minority of patients present with
resectable disease but relapse rates are high; benefit from adjuvant capecitabine
chemotherapy has been demonstrated. Cisplatin/gemcitabine combination
chemotherapy has emerged as the reference first-line treatment regimen; there is
no standard second-line therapy. Selected patients may be suitable for
liver-directed therapy (e.g., radioembolization or external beam radiation),
pending confirmation of benefit in randomized studies. Initial trials targeting
the epithelial growth factor receptor and angiogenesis pathways have failed to
deliver new treatments. Emerging data from next-generation sequencing analyses
have identified actionable mutations (e.g., FGFR fusion rearrangements and IDH1
and IDH2 mutations), with several targeted drugs entering clinical development
with encouraging results. The role of systemic therapies, including targeted
therapies and immunotherapy for BTC, is rapidly evolving and is the subject of
this review.Significance: The authors address genetic drivers and molecular
biology from a translational perspective, in an intent to offer a clear view of
the recent past, present, and future of BTC. The review describes a
state-of-the-art update of the current status and future directions of research
and therapy in advanced BTC. Cancer Discov; 7(9); 1-20. ©2017 AACR.

©2017 American Association for Cancer Research.

DOI: 10.1158/2159-8290.CD-17-0245
PMID: 28818953