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Targeted therapies in advanced biliary tract cancers-a narrative review
Michael LaPelusa1, Thatcher Heumann2, Laura Goff2
1Department of Internal Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
Chinese Clinical Oncology
|March 22, 2023
Summary
Targeted therapies show promise for improving survival in advanced biliary tract cancers (BTCs). Ongoing research into genomic alterations continues to expand treatment options for patients with cholangiocarcinoma and gallbladder cancer.
Area of Science:
- Oncology
- Genomics
- Molecular Biology
Background:
- Biliary tract cancers (BTCs), including cholangiocarcinoma and gallbladder cancer, present a significant clinical challenge due to their poor prognosis.
- Next-generation sequencing has identified actionable somatic aberrations in BTCs, paving the way for targeted treatment strategies.
Approach:
- A comprehensive literature search identified phase I, II, and III clinical trials of targeted therapies for advanced BTCs published between 2010 and 2022.
- Searches of Medline (PubMed) and ClinicalTrials.gov utilized keywords related to BTCs and targeted therapies, yielding 415 relevant studies.
Key Points:
- Immune checkpoint inhibitors, fibroblast growth factor receptor (FGFR) inhibitors, isocitrate dehydrogenase (IDH) inhibitors, and human epidermal growth factor receptor 2 (HER2)-directed therapies have demonstrated efficacy in advanced BTCs.
- Several other novel agents are under investigation in early-phase clinical trials.
Conclusions:
- Targeted agents offer improved survival outcomes for patients with advanced BTCs, expanding therapeutic options for refractory disease.
- The evolving landscape of BTC treatment is driven by advancements in detecting genomic alterations and developing corresponding targeted therapies.
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