Adjuvant therapy in biliary tract tumors: how will immunotherapy fit in the future?

Biliary tract tumors comprise a group of poor prognosis malignancies, most of them being diagnosed at an advanced stage. Standard treatments include surgery with curative intent and adjuvant chemotherapy. Even so, the benefit obtained is marginal, and relapses are frequent.

Here, we made a review of the literature trying to summarize all trials related to adjuvant therapy, as well as those yet to come. We also focused on detecting the unmet needs in this field, which may represent a change in the current strategy.

A clear definition of resectability, risk stratification, intensification of treatment with immunotherapy, and targeted therapies, as well as moving treatment from an adjuvant to a perioperative scenario are, in our view, factors that could increase the rate of cure in this scenario.