New Treatment Options for Advanced Biliary Tract Cancer.
Curr Treat Options Oncol
; 21(8): 63, 2020 06 29.
Article
in En
| MEDLINE
| ID: mdl-32602010
ABSTRACT
OPINION STATEMENT The standard of care first-line therapy for patients with advanced biliary tract cancers eligible for treatment continues to be the combination of gemcitabine and cisplatin. Based on the promising results of a phase II study, an ongoing multi-institutional phase III study is assessing the benefit of adding nab-paclitaxel to the chemotherapy doublet, and appropriate patients should be considered for enrollment at participating centers. We would recommend early comprehensive genomic profiling of patients' tumors to identify potentially targetable aberrations with available therapies. Results with therapeutic implications include tumors with microsatellite instability/deficient mismatch repair, alterations in FGFR, IDH1/2, and HER-2, and potentially other molecular vulnerabilities. Patients in whom a targetable genomic abnormality is found should be matched with appropriate agent. If a targetable fusion or mutation is not detected, patients eligible for second-line therapy should be considered for either clinical trial enrollment or a second-line cytotoxic chemotherapy regimen such as modified FOLFOX. Strategies incorporating immunotherapy into the treatment of patients with microsatellite stable advanced biliary tract cancers have yielded largely disappointing results thus far, and routine use of checkpoint inhibitors outside of a clinical trial is not recommended.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Biliary Tract Neoplasms
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Prognostic_studies
Limits:
Humans
Language:
En
Journal:
Curr Treat Options Oncol
Journal subject:
NEOPLASIAS
Year:
2020
Document type:
Article
Affiliation country:
United States