[The research progress of neoadjuvant and conversion therapy in biliary tract carcinoma]

Biliary tract carcinoma (BTC) is a highly aggressive malignancy,and the majority of patients present with advanced stage at first diagnosis which resulting in poor prognosis. Traditional chemotherapy and monotherapy have shown limited efficacy in treating BTC. However,with the continuous emergence of clinical research findings and updates to relevant guidelines,there have been some breakthroughs in systemic therapies for BTC. This paper analyzes domestic and international literature on neoadjuvant therapy and conversion therapy for BTC,aiming to provide a reference for clinical research. Overall,research on neoadjuvant therapy and conversion therapy remains in the preliminary exploration phase. Current evidence suggests that combination strategies involving immunotherapy and chemotherapy,with or without targeted therapy,have demonstrated promising clinical efficacy,offering new hope for neoadjuvant therapy and conversion therapy in BTC. Furthermore,the evolution of precision targeted therapies offers better opportunities for personalized treatment,and the combination of local interventions and systemic therapies demonstrates promising therapeutic potential. However,the optimal strategies and timing for surgery of neoadjuvant therapy and conversion therapy have not yet been standardized. Moreover,most studies lack precise designs to address the heterogeneity of BTC,new therapies have not yet reached the ideal stage of personalized treatment,further research is warranted to address these challenges.