Current and novel therapeutic opportunities for systemic therapy in biliary cancer
José J G Marin, Maria Giuseppina Prete, Angela Lamarca, Simona Tavolari, Ana Landa-Magdalena, Giovanni Brandi, Oreste Segatto, Arndt Vogel, Rocío I R Macias, Pedro M Rodrigues, Adelaida La Casta, Joachim Mertens, Cecilia M P Rodrigues, Maite G Fernandez-Barrena, Ana Da Silva Ruivo, Marco Marzioni, Giulia Mentrasti, Pilar Acedo, Patricia Munoz-Garrido, Vincenzo Cardinale, Jesus M Banales, Juan W Valle, John Bridgewater, Chiara Braconi, working group 6 of the COST-action 18122 (Euro-Cholangio-NET) as part of the European Network for the study of Cholangiocarcinoma (ENSCCA)
Biliary tract cancers (BTCs) are a group of rare and aggressive malignancies that arise in the biliary tree within and outside the liver. Beyond surgical resection, which is beneficial for only a small proportion of patients, current strategies for treating patients with BTCs include chemotherapy, as a single agent or combination regimens, in the adjuvant and palliative setting. Increased characterisation of the molecular landscape of these tumours has facilitated the identification of molecular vulnerabilities, such as IDH mutations and FGFR fusions, that can be exploited for the treatment of BTC patients.
Beyond targeted therapies, active research avenues explore the development of novel therapeutics that target the crosstalk between cancer and stroma, the cellular pathways involved in the regulation of cell death, the chemoresistance phenotype and the dysregulation of RNA. In this review, we discuss the therapeutic opportunities currently available in the management of BTC patients, and explore the strategies that can support the implementation of precision oncology in BTCs, including novel molecular targets, liquid biopsies and patient-derived predictive tools.
CITA DEL ARTÍCULO Br J Cancer. 2020 Sep;123(7):1047-1059. doi: 10.1038/s41416-020-0987-3.