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Immunotherapy in Advanced Biliary Tract Cancers

Alice Boilève1,2, Marc Hilmi3, Cristina Smolenschi1,3

  • 1Département de Médecine Oncologique, Gustave Roussy, F-94805 Villejuif, France.

Cancers
|April 3, 2021
PubMed

Insights

Biliary tract cancers have poor prognoses, with immunotherapy showing promise for select patients. Identifying biomarkers is crucial for effective immunotherapy selection in these rare liver malignancies.

Area of Science:

  • Oncology
  • Immunotherapy
  • Gastroenterology

Background:

  • Biliary tract cancers (BTCs) are rare and often diagnosed at advanced stages.
  • Current therapeutic options for advanced BTC are limited, with a poor prognosis.
  • Immunotherapy, particularly immune checkpoint inhibitors, is emerging but largely investigational for BTC.

Purpose of the Study:

  • To review the current landscape of immunotherapy in biliary tract cancers.
  • To highlight the need for predictive biomarkers to guide immunotherapy selection.
  • To discuss ongoing investigations into combination therapies for BTC.

Main Methods:

  • Review of current literature on immunotherapy in biliary tract cancers.
  • Analysis of the role of immune checkpoint inhibitors, including pembrolizumab.
  • Discussion of emerging combination strategies involving immunotherapy, chemotherapy, and targeted therapies.

Main Results:

  • Pembrolizumab is approved only for microsatellite-instable BTC.
  • Single-agent immune checkpoint blockade shows limited activity in microsatellite-stable BTC.
  • A subgroup of patients may benefit from immunotherapy, but requires biomarker identification.

Conclusions:

  • Predictive biomarker identification is essential for optimizing immunotherapy in biliary tract cancers.
  • Combination therapies are under investigation in early lines of treatment for BTC.
  • Further research is needed to improve immunotherapy efficacy and patient selection in BTC.
Keywords:
biliary tract cancerscholangiocarcinomadrug combinationimmune checkpoint inhibitorimmunotherapyvaccine

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