Advances in Immunooncology and Precision Medicine in Cholangiocarcinoma

Timothy J. Brown, T. Karasic
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Abstract

Cholangiocarcinoma (CCA) is an uncommon but morbid cancer arising from the intrahepatic or extrahepatic bile ducts. CCA is frequently asymptomatic at early stages and is often unresectable or metastatic at the time of initial diagnosis. While chemotherapy remains the mainstay of treatment for most patients with advanced disease, the addition of immunotherapy to frontline treatment has improved survival and provided an alternative to perpetual chemotherapy. Furthermore, a variety of targeted therapies have demonstrated benefit in patients with specific biomarkers including FGFR2 fusions, IDH1 mutations, HER2 overexpression, and tumor agnostic markers such as NTRK and RET fusions, among others. This review will summarize the established roles of immunotherapy, targeted therapies, and their combinations in CCA as well as treatment strategies that are under development with potential to impact clinical practice in the coming years.
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胆管癌免疫肿瘤学和精准医学的进展
胆管癌(Colangiocarcinoma,CCA)是一种不常见但发病率很高的癌症,它发生于肝内或肝外胆管。CCA 在早期阶段通常没有症状,在初次诊断时往往无法切除或已经转移。虽然化疗仍是大多数晚期患者的主要治疗手段,但在一线治疗中加入免疫疗法后,患者的生存率得到了提高,并为长期化疗提供了一种替代方案。此外,多种靶向疗法已证明对具有特定生物标志物的患者有益,这些标志物包括 FGFR2 融合、IDH1 突变、HER2 过表达以及 NTRK 和 RET 融合等肿瘤不可知标志物。本综述将总结免疫疗法、靶向疗法及其联合疗法在 CCA 中的既定作用,以及正在开发并有可能在未来几年对临床实践产生影响的治疗策略。
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