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Second-line therapies in advanced biliary tract cancers
Sri Harsha Tella1, Anuhya Kommalapati2, Mitesh J Borad3
1Department of Medicine, School of Medicine, University of South Carolina, Columbia, SC, USA.
The Lancet. Oncology
|January 8, 2020
Summary
Second-line therapy for advanced biliary tract cancers lacks guidelines. Understanding molecular pathogenesis aids in selecting personalized treatments for improved outcomes in biliary tract cancer patients.
Area of Science:
- Oncology
- Gastroenterology
- Molecular Biology
Background:
- Biliary tract cancers (BTCs) are rare gastrointestinal malignancies with a poor prognosis.
- Current treatment for advanced or unresectable BTCs relies on chemotherapy, with gemcitabine and cisplatin as a standard first-line option.
- Lack of consensus exists for optimal second-line therapy selection in BTC.
Purpose of the Study:
- To review current literature on advanced biliary tract cancer treatment.
- To discuss potential second-line systemic therapy options based on molecular pathogenesis.
- To address the need for personalized medicine in advanced BTC.
Main Methods:
- Literature review of studies on biliary tract cancer tumorigenesis and treatment.
- Analysis of genetic landscape and molecular alterations in BTC subtypes.
- Discussion of potential targeted therapies and systemic options.
Main Results:
- Significant advancements in understanding BTC molecular subtypes and genetic landscape.
- Identification of common implicated genes in BTC tumorigenesis (e.g., IDH1/2, FGFRs, HER2, BRAF).
- Emerging potential for targeted therapies in precision medicine for BTC.
Conclusions:
- Personalized medicine approaches are crucial for advanced BTC.
- Further research is needed to define optimal second-line regimens and their impact on quality of life.
- Molecular profiling can guide treatment selection for improved patient outcomes in biliary tract cancer.
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