Systemic approaches in biliary tract cancers: a review in the era of multidirectional precision medicine.

IF 2.5 3区 医学 Q3 PHARMACOLOGY & PHARMACY Expert Opinion on Pharmacotherapy Pub Date : 2024-12-01 Epub Date: 2024-11-24 DOI:10.1080/14656566.2024.2432488
Cha Len Lee, Anna Saborowski, Arndt Vogel
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Abstract

Introduction: Despite a rising incidence, biliary tract cancers (BTCs) are still considered a rare tumor entity. The disease's subtle clinical presentation and lack of effective early detection strategies often lead to a diagnosis at an advanced or unresectable stage, where curative options are limited.

Areas covered: This review provides an overview of current systemic therapies and emerging novel approaches for BTC. For decades, the combination of gemcitabine with cisplatin (GemCis) has been the standard of care for palliative treatment. However, since 2020, the diagnostic and therapeutic landscape for BTC has evolved considerably, not only in the first-line setting but also beyond, driven by the development of clinical trials exploring immunotherapy and molecularly targeted agents. Due to the high frequency of targetable genetic alterations in BTC patients, there is a growing emphasis on obtaining tissue or liquid biopsy samples to identify markers like microsatellite instability and other actionable oncogenic driver genes.

Expert opinion: Early initiation of systemic therapies in combination with multimodal approaches is essential for maximizing survival outcomes in patients with BTC.

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胆道癌症的系统治疗方法:多向精准医疗时代的综述。
导言:尽管胆道癌(BTC)的发病率不断上升,但仍被认为是一种罕见的肿瘤实体。这种疾病的临床表现微妙,且缺乏有效的早期检测策略,因此往往在晚期或无法切除的阶段才被确诊,治疗方案十分有限:本综述概述了目前治疗 BTC 的系统疗法和新出现的新型方法。几十年来,吉西他滨联合顺铂(GemCis)一直是姑息治疗的标准疗法。然而,自 2020 年以来,在探索免疫疗法和分子靶向药物的临床试验发展的推动下,BTC 的诊断和治疗格局发生了很大变化,不仅在一线治疗中,而且在一线治疗之外。由于 BTC 患者中可靶向的基因改变频率较高,人们越来越重视获取组织或液体活检样本,以确定微卫星不稳定性等标记物和其他可操作的致癌驱动基因:专家意见:尽早开始系统治疗并结合多模式方法,对于最大限度地提高 BTC 患者的生存率至关重要。
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来源期刊
CiteScore
5.60
自引率
3.10%
发文量
163
审稿时长
4-8 weeks
期刊介绍: Expert Opinion on Pharmacotherapy is a MEDLINE-indexed, peer-reviewed, international journal publishing review articles and original papers on newly approved/near to launch compounds mainly of chemical/synthetic origin, providing expert opinion on the likely impact of these new agents on existing pharmacotherapy of specific diseases.
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