TY - JOUR
T1 - Second-line therapies in advanced biliary tract cancers
AU - Tella, Sri Harsha
AU - Kommalapati, Anuhya
AU - Borad, Mitesh J.
AU - Mahipal, Amit
N1 - Funding Information:
We retrieved research articles published in English between Jan 1, 1990, and Sept 31, 2019, from PubMed and ClinicalTrials.gov . Our search terms were “biliary tract cancer”, “cholangiocarcinoma”, “gallbladder cancer”, and “cancer of bile ducts”. We also included literature published as abstracts at international meetings such as the American Society of Clinical Oncology, European Society of Medical Oncology, and American Association of Cancer Research. Articles were also identified through searches of the authors' own files. Contributors Figures were prepared by SHT, AK, and AM. All authors contributed to the individual sections of the manuscript and reviewed and approved the final version. Declaration of interests MJB received grants from Fujifilm, Agios Pharmaceuticals, Halozyme Therpaeutics, Incyte Corporation, Basilea Pharmaceutica, Senhwa Biosciences, Toray Pharmaceuticals, EMD Serono, Pieris Pharmaceuticals, Sun BioPharma, Mirna Therapeutics, BiolineRx, ARIAD Pharmaceuticals, Puma Biotechnology, Novartis, and QED Therapeutics; and personal fees from G1 Therapeutics, Inspyr Therapeutics, Exelixis, Immunovative Therapies, OncBioMune Pharmaceuticals, Antibody Drug Conjugate Therapeutics, Systems Oncology, Western Oncolytics, and the Lynx Group, outside the submitted work. All other authors declare no competing interests.
Publisher Copyright:
© 2020 Elsevier Ltd
PY - 2020/1
Y1 - 2020/1
N2 - Biliary tract cancers constitute approximately 3% of gastrointestinal malignancies with poor prognosis. Surgical therapy is the main form of treatment in localised disease; however, for patients with advanced stage or unresectable disease, locoregional and systemic chemotherapeutics are primary treatment options. Although the combination of gemcitabine and cisplatin is a standard regimen of choice, there are no consensus guidelines that help in choosing an appropriate second-line therapy. Substantial progress has been made in the past decade to understand the tumorigenesis and genetic landscape of each biliary tract cancer subtype, which facilitates precision medicine for this cancer. Common genes implicated in biliary tract cancer tumorigenesis include IDH1, IDH2, FGFR1, FGFR2, FGFR3, EPHA2, BAP1, ARID1B, ELF3, PBRM1, PRKACA, PRKACB, HER2, and BRAF. With the advancements in molecular pathogenesis of biliary tract cancer, especially in an era of personalised medicine, many questions are yet to be answered in advanced stages of the cancer: what subset of patients might benefit from second-line drugs, how to choose an optimal second-line regimen, and their effects on quality of life. This Review seeks to summarise available literature and discuss the potential second-line systemic therapy options for advanced biliary tract cancer on the basis of advancements of our knowledge on molecular pathogenesis and tumorigenesis.
AB - Biliary tract cancers constitute approximately 3% of gastrointestinal malignancies with poor prognosis. Surgical therapy is the main form of treatment in localised disease; however, for patients with advanced stage or unresectable disease, locoregional and systemic chemotherapeutics are primary treatment options. Although the combination of gemcitabine and cisplatin is a standard regimen of choice, there are no consensus guidelines that help in choosing an appropriate second-line therapy. Substantial progress has been made in the past decade to understand the tumorigenesis and genetic landscape of each biliary tract cancer subtype, which facilitates precision medicine for this cancer. Common genes implicated in biliary tract cancer tumorigenesis include IDH1, IDH2, FGFR1, FGFR2, FGFR3, EPHA2, BAP1, ARID1B, ELF3, PBRM1, PRKACA, PRKACB, HER2, and BRAF. With the advancements in molecular pathogenesis of biliary tract cancer, especially in an era of personalised medicine, many questions are yet to be answered in advanced stages of the cancer: what subset of patients might benefit from second-line drugs, how to choose an optimal second-line regimen, and their effects on quality of life. This Review seeks to summarise available literature and discuss the potential second-line systemic therapy options for advanced biliary tract cancer on the basis of advancements of our knowledge on molecular pathogenesis and tumorigenesis.
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U2 - 10.1016/S1470-2045(19)30733-8
DO - 10.1016/S1470-2045(19)30733-8
M3 - Review article
C2 - 31908303
AN - SCOPUS:85077147126
VL - 21
SP - e29-e41
JO - The Lancet Oncology
JF - The Lancet Oncology
SN - 1470-2045
IS - 1
ER -