scholarly journals Dual HER2 Blockade: An Emerging Option in Metastatic Biliary Tract Cancer?

Medicina ◽  
2021 ◽  
Vol 57 (12) ◽  
pp. 1301
Author(s):  
Angela Dalia Ricci ◽  
Alessandro Rizzo
Keyword(s):  
Gallbladder Cancer ◽  
Biliary Tract ◽  
Intrahepatic Cholangiocarcinoma ◽  
Biliary Tract Cancer ◽  
Heterogeneous Group ◽  
Perihilar Cholangiocarcinoma ◽  
Extrahepatic Cholangiocarcinoma ◽  
Tract Cancer ◽  
Hepatobiliary Malignancies

Biliary tract cancer (BTC) includes a heterogeneous group of aggressive and rare hepatobiliary malignancies, including gallbladder cancer, ampullary carcinomas, intrahepatic cholangiocarcinoma (iCCA), and extrahepatic cholangiocarcinoma, further subclassified into distal (dCCA) and perihilar cholangiocarcinoma (pCCA) [...]

scholarly journals Intrahepatic Cholangiocarcinoma: Evolving Concepts and Medical Treatment

2021 ◽  
Vol 26 (1) ◽  
pp. 33-42
Author(s):  
Hong Ja Kim
Keyword(s):  
Biliary Tract ◽  
Intrahepatic Cholangiocarcinoma ◽  
Biliary Tract Cancer ◽  
Chemotherapeutic Agents ◽  
Growth Patterns ◽  
Classification Systems ◽  
Anatomical Location ◽  
Extrahepatic Cholangiocarcinoma ◽  
Distal Cholangiocarcinoma ◽  
Tract Cancer

Cholangiocarcinoma (bile duct cancer) is classified into intrahepatic and extrahepatic cholangiocarcinoma (perihilar and distal cholangiocarcinoma) according to the anatomical location of the lesion. The incidence of extrahepatic cholangiocarcinoma has been relatively stagnant in recent decades, but intrahepatic cholangiocarcinoma is steadily increasing worldwide, requiring attention. Various classification systems based on gross growth patterns, histological findings, and tumor-derived cells, as well as classification based on existing anatomical location, have been proposed, however, the consensus has not been established yet. Intrahepatic cholangiocarcinoma is a carcinoma with an extremely poor prognosis. Complete tumor resection is the only curative treatment. The overall survival rate for 5 years after surgery is 15% to 40%, but recurrence after surgery is observed in 2/3 patients. Therefore, determining the right stage before surgery and selecting an appropriate treatment method through a multidisciplinary approach is a very important process in determining proper treatment. Systemic therapy may be used for locally advanced biliary tract cancer or metastatic biliary tract cancer where surgery is not possible. However, the effectiveness of traditional anticancer chemotherapeutic agents is rather pessimistic, therefore treatments using molecular biological properties have recently been attempted. Finding a way to increase the number of resectable cases through early diagnosis is one of the main challenges. In addition, it is also hoped that the selection of new therapeutic targets and therapeutics will be possible as a result of advanced research on gene expression profiles and mutations in cholangiocarcinoma.

scholarly journals Efficacy and Safety of Pembrolizumab for Gemcitabine/Cisplatin-Refractory Biliary Tract Cancer: A Multicenter Retrospective Study

2020 ◽  
Vol 9 (6) ◽  
pp. 1769 ◽  
Author(s):  
Sang Hoon Lee ◽  
Hee Seung Lee ◽  
Sang Hyub Lee ◽  
Sang Myung Woo ◽  
Dong Uk Kim ◽  
...  
Keyword(s):  
Cell Death ◽  
Programmed Cell Death ◽  
Biliary Tract ◽  
Biliary Tract Cancer ◽  
Progression Free Survival ◽  
Cancer Type ◽  
Extrahepatic Cholangiocarcinoma ◽  
Tract Cancer ◽  
Tertiary Hospitals ◽  
Melanoma Treatment

Pembrolizumab, an anti-programmed cell death (PD)-1 monoclonal antibody, is an anticancer agent showing substantial benefit in lung cancer and melanoma treatment. Biliary tract cancer (BTC) has been shown to respond to pembrolizumab; however, no credible data of such treatment outcomes exist. Therefore, we assessed the clinical outcomes and safety of pembrolizumab in patients with gemcitabine/cisplatin-refractory BTC. In this multicenter study, we retrospectively analyzed 51 patients with programmed cell death 1-ligand 1 (PD-L1)-positive gemcitabine/cisplatin-refractory BTC treated with pembrolizumab in four tertiary hospitals in Korea. PD-L1 positivity was defined as the expression of PD-L1 in ≥1% of tumor cells based on immunohistochemical staining (22C3, SP263, and E1L3N assays). The median age of the patients was 66 (range, 43–83) years and 29 (56.9%) were male. Extrahepatic cholangiocarcinoma was the most common cancer type (n = 30, 58.8%). Partial response and stable disease were achieved in 5 (9.8%) and 13 (25.5%) patients, respectively. Median progression-free survival and overall survival were 2.1 (95% CI, 1.7–2.4) and 6.9 (95% CI, 5.4–8.3) months, respectively. Overall, 30 (58.8%) patients experienced treatment-related adverse events (AEs). Only four (7.8%) patients experienced grades 3 and 4 AEs. In PD-L1-positive gemcitabine/cisplatin-refractory BTC, pembrolizumab presented durable efficacy, with a 9.8% response rate and manageable toxicity.

Frequency of BRCA mutation in biliary tract cancer and its correlation with tumor mutational burden (TMB) and microsatellite instability (MSI).

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 4085-4085 ◽  
Author(s):  
Gilbert Spizzo ◽  
Alberto Puccini ◽  
Joanne Xiu ◽  
Richard M. Goldberg ◽  
Axel Grothey ◽  
...  
Keyword(s):  
Biliary Tract ◽  
Biliary Tract Cancer ◽  
Brca Mutation ◽  
Treatment Strategies ◽  
Missense Mutations ◽  
Brca Mutations ◽  
Extrahepatic Cholangiocarcinoma ◽  
Similar Frequency ◽  
Biliary Tract Cancers ◽  
Tract Cancer

4085 Background: Biliary tract cancers constitute ~3% of cancers worldwide with incidence increasing, especially for intrahepatic cholangiocarcinoma (IHC). The prognosis of these tumors remains dismal and novel treatment strategies are needed to improve overall survival. BRCA mutations occur in biliary tract cancers but their frequency in distinct sites of biliary tract cancer is unknown. Moreover, no data are available correlating BRCA mutation with immunogenic markers such as TMB, MSI, or PD-L1 expression. Methods: Tumor samples from 1288 primary biliary tract cancers, comprising IHC (n = 746), extrahepatic cholangiocarcinoma (EHC) (n = 189), gallbladder (GBC) (n=353) were profiled at Caris Life Sciences, Phoenix, AZ. Testing included NextGen SEQ (MiSeq on 47 genes, NextSeq on 592 genes) and PD-L1 IHC (SP142). TMB was calculated based on somatic nonsynonymous missense mutations, and MSI was evaluated by NGS of known MSI loci. Results: BRCA mutations were detected in 3.6% (N = 46) of samples ( BRCA1 0.6%, BRCA2 3%), no differences were seen based on the site of the tumor. In GBC and IHC BRCA2 mutations (4.0% and 2.7%) were more frequent than BRCA1 (0.3% and 0.4, p < 0.05) while in EHC, similar frequency was observed ( BRCA1: 2.1%; BRCA2: 2.6%). There was no significant association with gender or age. In BRCA-mutant biliary tract cancer the most frequently mutated genes were TP53 (55.6%), ARID1A (52.2%) and KRAS (26.1%), KMT2D/C (20%, 13%) and CDKN2A(13%). Overall, BRCA mutations were associated with a higher rate of MSI-H (19.5% vs 1.7%, p = 0.001) and higher TMB in both MSI-H and MSS tumors (p<0.05). When investigated separately, BRCA association with elevated TMB was seen in IHC and EHC, but not in GBC. No correlation was seen with PD-L1 expression. TP53, KMT2D/C, RB1, PTEN, KDM6A mutations and FGFR1 amplifications were significantly higher in BRCA mutated tumors (p < 0.05). Conclusions: BRCA mutations are found in a significant subgroup of biliary tract tumors and are associated with an immunogenic tumor profile. These data provide rationale for trials testing PARP inhibitors in combination with immunotherapy and targeted therapies in patients with BRCA-mutant biliary tract cancers that are MSS.

Treatment efficacy in patients with advanced biliary tract cancer receiving gemcitabine and cisplatin and 21-h infusional 5-FU: An analysis of 17 cases.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e15195-e15195
Author(s):  
Mozaffar Aznab ◽  
Kiumars Eslam pia ◽  
Khosro Setayeshi ◽  
Mansour Rezaei ◽  
Kaveh Kavianymoghadam
Keyword(s):  
Lymph Node ◽  
Liver Metastasis ◽  
Gallbladder Cancer ◽  
Biliary Tract ◽  
Biliary Tract Cancer ◽  
Medical Sciences ◽  
Curative Surgery ◽  
Local Invasion ◽  
Tract Cancer ◽  
Age Range

e15195 Background:Biliary tract a group of tumors which only a minority of patients is eligible for curative surgery. The purpose of this study was to identify efficacy treatment of gemcitabine, cisplatin, and 21h infusional 5-FU in patients with advanced BTC receiving this therapy, and the median time to progression and OS time. Methods: The data of 17 patients with advanced biliary tract cancer who referred to clinic oncology of Kermanshah University of Medical Sciences, which received treatment from January 2009 to December 2012 were collected. Patients with gallbladder cancer with local invasion into near structures or metastatic to lymph node and or liver and or peritoneal seeding and also patients with cholangiocarcinom were randomized to recieveing chemotherapy consisting of cycles of continuous infusion of 5-FU for 21-hours (600 mg/m2) days 1, 2, 3, and 4. Gemcitabine was given at dose of 1,250 mg/m2 days 1 and 8 and cisplatin was given at dose of 60 mg/m2 day 1 with G-csf every support. Each cycle repeated every 21 days for 6-7 cycles. Results: A total of 17 patients with age range 41-61 years studied.58.8% female and 41.2% were male. The 11 patients were gallbladder cancer with only local invasion into surrounding structures in 7 pts and 2 pts with only lymph node and peritoneal involving and 2 pts with lymph node and peritoneal involving and liver metastasis, and 6 patients were cholangiocarcinoma with lymph node and peritoneal involving in 3 pts and one pts with lymph node involving and one pts with liver metastasis. Four out of the 11 patients with gallbladder cancer with local invasion survived above 29 months one pts above 20 months. Means and medians for TTP of 6 pts which disease progressed was 11.2 and 9.6 months, respectively. Means for OS Time of 17 pts was 32 months. The overall 75.5% of pts are alive. This regimen was well tolerated, with neutropenia and thrombocytopenia as the most significant toxicities. Conclusions: The triple therapy with Gemcitabine cisplatin, 5-FU showed efficacy with manageable toxicity in patients with advanced BTC and demonstrated that the addition infusional 5-FU to cisplatin and gemcitabine afforded significant PFS and OS benefits.

scholarly journals P-0144 Adjuvant Therapy and Prognostic Factors for Biliary Tract Cancer Intrahepatic Cholangiocarcinoma: Single-Center Experience

2012 ◽  
Vol 23 ◽  
pp. iv72
Author(s):  
Joaquina Martinez-Galan ◽  
Javier Garcia Garcia ◽  
Karim Muffa K-Granero ◽  
José Antonio Ortega ◽  
Beatriz Gonzalez-Astorga ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Adjuvant Therapy ◽  
Biliary Tract ◽  
Intrahepatic Cholangiocarcinoma ◽  
Biliary Tract Cancer ◽  
Single Center ◽  
Tract Cancer ◽  
Single Center Experience

scholarly journals Gallbladder Cancer: a Subtype of Biliary Tract Cancer Which is a Current Challenge in China

2012 ◽  
Vol 13 (4) ◽  
pp. 1317-1320 ◽  
Author(s):  
Kai Qu ◽  
Si-Nan Liu ◽  
Hu-Lin Chang ◽  
Chang Liu ◽  
Xin-Sen Xu ◽  
...  
Keyword(s):  
Gallbladder Cancer ◽  
Biliary Tract ◽  
Biliary Tract Cancer ◽  
Tract Cancer ◽  
Current Challenge ◽  
A Current

Biliary Tract Cancer

2017 ◽  
Author(s):  
Jill Koshiol ◽  
Catterina Ferreccio ◽  
Susan S. Devesa ◽  
Juan Carlos Roa ◽  
Joseph F. Fraumeni
Keyword(s):  
United States ◽  
Gallbladder Cancer ◽  
Biliary Tract ◽  
Biliary Tract Cancer ◽  
Bile Ducts ◽  
The United States ◽  
Ampulla Of Vater ◽  
Biliary Tract Cancers ◽  
Tract Cancer ◽  
Extrahepatic Bile Ducts

Biliary tract cancers encompass tumors of the gallbladder, extrahepatic bile ducts, and ampulla of Vater. In the United States, biliary tract cancer is the fifth most common malignant neoplasm of the digestive tract, accounting for about 3,700 deaths per year. The gallbladder is the primary subsite for 40% of biliary tract cancers, followed by the extrahepatic bile ducts (33%), ampulla of Vater (20%), and unspecified subsite (8%). Gallbladder cancer occurs twice as often in women than men, while other biliary tumors are more common in men. Risk of gallbladder cancer is elevated in Amerindians, including the Pima Indians in the United States and the Mapuches in Chile, and in certain Hispanic populations. While a significant fraction of these tumors are related to underlying gallstones (cholelithiasis), information on other risk factors is limited, due to the rarity of the tumors, the often rapidly fatal course, and small number of epidemiologic studies.

scholarly journals Adjuvant Therapy for Resected Biliary Tract Cancer: ASCO Clinical Practice Guideline

2019 ◽  
Vol 37 (12) ◽  
pp. 1015-1027 ◽  
Author(s):  
Rachna T. Shroff ◽  
Erin B. Kennedy ◽  
Melinda Bachini ◽  
Tanios Bekaii-Saab ◽  
Christopher Crane ◽  
...  
Keyword(s):  
Decision Making ◽  
Clinical Practice ◽  
Adjuvant Therapy ◽  
Biliary Tract ◽  
Clinical Practice Guideline ◽  
Biliary Tract Cancer ◽  
Phase Iii ◽  
Extrahepatic Cholangiocarcinoma ◽  
Tract Cancer ◽  
Randomized Controlled

PURPOSE To develop an evidence-based clinical practice guideline to assist in clinical decision making for patients with resected biliary tract cancer. METHODS ASCO convened an Expert Panel to conduct a systematic review of the literature on adjuvant therapy for resected biliary tract cancer and provide recommended care options for this patient population. RESULTS Three phase III randomized controlled trials, one phase II trial, and 16 retrospective studies met the inclusion criteria. RECOMMENDATIONS Based on evidence from a phase III randomized controlled trial, patients with resected biliary tract cancer should be offered adjuvant capecitabine chemotherapy for a duration of 6 months. The dosing used in this trial is described in the qualifying statements, while it should be noted that the dose of capecitabine may also be determined by institutional and regional practices. Patients with extrahepatic cholangiocarcinoma or gallbladder cancer and a microscopically positive surgical resection margin (R1 resection) may be offered chemoradiation therapy. A shared decision-making approach is recommended, considering the risk of harm and potential for benefit associated with radiation therapy for patients with extrahepatic cholangiocarcinoma or gallbladder cancer. Additional information is available at www.asco.org/gastrointestinal-cancer-guidelines .

scholarly journals Endoscopic ultrasonography confirmed recurrence of gallbladder cancer: a case report (with a video).

2021 ◽  
Author(s):  
Lifen Xu ◽  
Duanmin Hu
Keyword(s):  
Case Report ◽  
Gallbladder Cancer ◽  
Biliary Tract ◽  
Malignant Tumor ◽  
Biliary Tract Cancer ◽  
Radical Resection ◽  
Late Recurrence ◽  
High Grade ◽  
Recurrent Cancer ◽  
Tract Cancer

Biliary tract cancer is the most common biliary malignant tumor, which is considered to be a high-grade malignant tumor because of its frequent recurrence / metastasis[1]. Late recurrence of gallbladder cancer after operation is rare. We presented a case of recurrent cancer after radical resection of gallbladder cancer.

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