Pub Date : 2023-08-03DOI: 10.20517/2394-5079.2023.51
S. Ruff, Mary E. Dillhoff
Cholangiocarcinoma (CCA) is an aggressive malignancy that arises from the biliary tract. Currently, the first-line therapy for advanced CCA is gemcitabine and cisplatin. However, 5-year survival remains low. It has become abundantly clear that a “one size fits all” approach no longer applies to the treatment of individual cancers, given the large amount of tumor heterogeneity. As such, research in recent years has focused on developing effective targeted therapies through genetic profiling of CCA tumors. IDH1 and IDH2 mutations are commonly found in intrahepatic CCA (ICCA). IDH mutations prevent hepatic progenitor cell differentiation and result in the persistence of progenitor-like and stem cells. These are more prone to alterations that promote tumor initiation. As such, IDH has been identified as a promising target for ICCA treatment. We herein review the role of IDH mutations in ICCA development, recent data for IDH inhibitors in ICCA treatment, and challenges within the field of targeted therapy for ICCA.
{"title":"Review of IDH mutations and potential therapies for intrahepatic cholangiocarcinoma","authors":"S. Ruff, Mary E. Dillhoff","doi":"10.20517/2394-5079.2023.51","DOIUrl":"https://doi.org/10.20517/2394-5079.2023.51","url":null,"abstract":"Cholangiocarcinoma (CCA) is an aggressive malignancy that arises from the biliary tract. Currently, the first-line therapy for advanced CCA is gemcitabine and cisplatin. However, 5-year survival remains low. It has become abundantly clear that a “one size fits all” approach no longer applies to the treatment of individual cancers, given the large amount of tumor heterogeneity. As such, research in recent years has focused on developing effective targeted therapies through genetic profiling of CCA tumors. IDH1 and IDH2 mutations are commonly found in intrahepatic CCA (ICCA). IDH mutations prevent hepatic progenitor cell differentiation and result in the persistence of progenitor-like and stem cells. These are more prone to alterations that promote tumor initiation. As such, IDH has been identified as a promising target for ICCA treatment. We herein review the role of IDH mutations in ICCA development, recent data for IDH inhibitors in ICCA treatment, and challenges within the field of targeted therapy for ICCA.","PeriodicalId":12959,"journal":{"name":"Hepatoma Research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67654540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-01DOI: 10.20517/2394-5079.2023.40
Wenjie Hou, Yifan Tu, M. Zheng, Q. Zeng
The heterogeneity of tumors results in significantly distinct biological characteristics of intrahepatic cholangiocarcinoma (ICC) caused by different etiologies. Among them, ICC caused by intrahepatic lithiasis (IHL-ICC) presents challenges in early detection, tumor staging, and surgical treatment, and has the poorest prognosis among all etiologies of ICC patients. Thus, it is essential to focus on early assessment of the possibility of developing ICC, prompt intervention of intrahepatic lithiasis, anatomical resection of hepatic parenchyma corresponding to the branch of the intrahepatic bile duct undergoing cancerous transformation, and enhanced postoperative follow-up of hepatolithiasis and ICC for IHL-ICC patients. These interventions are crucial to improve the clinical outcomes and overall survival of IHL-ICC patients.
{"title":"Perspective of tumor heterogeneity for treatments of intrahepatic cholangiocarcinoma with intrahepatic lithiasis","authors":"Wenjie Hou, Yifan Tu, M. Zheng, Q. Zeng","doi":"10.20517/2394-5079.2023.40","DOIUrl":"https://doi.org/10.20517/2394-5079.2023.40","url":null,"abstract":"The heterogeneity of tumors results in significantly distinct biological characteristics of intrahepatic cholangiocarcinoma (ICC) caused by different etiologies. Among them, ICC caused by intrahepatic lithiasis (IHL-ICC) presents challenges in early detection, tumor staging, and surgical treatment, and has the poorest prognosis among all etiologies of ICC patients. Thus, it is essential to focus on early assessment of the possibility of developing ICC, prompt intervention of intrahepatic lithiasis, anatomical resection of hepatic parenchyma corresponding to the branch of the intrahepatic bile duct undergoing cancerous transformation, and enhanced postoperative follow-up of hepatolithiasis and ICC for IHL-ICC patients. These interventions are crucial to improve the clinical outcomes and overall survival of IHL-ICC patients.","PeriodicalId":12959,"journal":{"name":"Hepatoma Research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45831679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-01DOI: 10.20517/2394-5079.2023.02
S. Logarajah, John Nida, È. Simoneau, L. Yohanathan
The treatment of intrahepatic cholangiocarcinoma (iCCA) has traditionally been limited to surgical resection or systemic therapy. The role of liver transplantation in the management of iCCA is a topic currently being explored. This paper serves as a review to highlight past, present, and future work being done in regard to liver transplantation for iCCA. Strict protocols with specific selection criteria have shown promising results. Neoadjuvant therapy, locoregional therapy, and immunotherapy are some of the tools that may aid in bridging selected patients with iCCA to liver transplantation. There are currently three ongoing trials designed to further evaluate the efficacy of liver transplantation for iCCA. As criteria continue to be refined and evidence accumulates, liver transplantation may become a suitable option as a curative treatment strategy for highly selected patients with unresectable intraoperative cholangiocarcinoma.
{"title":"Insights on liver transplantation and multimodal treatment for intrahepatic cholangiocarcinoma","authors":"S. Logarajah, John Nida, È. Simoneau, L. Yohanathan","doi":"10.20517/2394-5079.2023.02","DOIUrl":"https://doi.org/10.20517/2394-5079.2023.02","url":null,"abstract":"The treatment of intrahepatic cholangiocarcinoma (iCCA) has traditionally been limited to surgical resection or systemic therapy. The role of liver transplantation in the management of iCCA is a topic currently being explored. This paper serves as a review to highlight past, present, and future work being done in regard to liver transplantation for iCCA. Strict protocols with specific selection criteria have shown promising results. Neoadjuvant therapy, locoregional therapy, and immunotherapy are some of the tools that may aid in bridging selected patients with iCCA to liver transplantation. There are currently three ongoing trials designed to further evaluate the efficacy of liver transplantation for iCCA. As criteria continue to be refined and evidence accumulates, liver transplantation may become a suitable option as a curative treatment strategy for highly selected patients with unresectable intraoperative cholangiocarcinoma.","PeriodicalId":12959,"journal":{"name":"Hepatoma Research","volume":"87 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67654173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-20DOI: 10.20517/2394-5079.2022.71
F. Caputo, M. Serenari, A. Palloni, M. Ravaioli, G. Brandi, M. Cescon
Intrahepatic cholangiocarcinoma (ICCA) incidence has been rising in the last few decades. Currently, hepatic resection is the only curative treatment for ICCA, and there is a lack of evidence supporting the use of preoperative treatment. A narrative review was conducted to analyze the available literature published on the role of neoadjuvant chemotherapy (CHT), either alone or combined with intra-arterial therapies (IAT), for downstaging unresectable ICCA to surgical resection. Most of the studies included in this review showed that secondary resection was associated with improvement in overall survival. In particular, studies analyzing CHT alone reported the highest conversion rate ranging from 20% to 57.1%, confirming that systemic treatment may yield the best results, and therefore, it should always be included as part of the neoadjuvant protocol. Among all the IATs, the longest overall survival reported was after CHT plus hepatic artery infusion, 25 months. Downsizing neoadjuvant multimodal approach, including combined systemic therapy with IAT, might improve the long-term outcomes of unresectable patients and expand surgical indications. However, randomized controlled trials are necessary to confirm their effectiveness.
{"title":"Neoadjuvant chemotherapy alone or combined with trans-arterial therapies for downstaging unresectable intrahepatic cholangiocarcinoma to surgical resection: a narrative review","authors":"F. Caputo, M. Serenari, A. Palloni, M. Ravaioli, G. Brandi, M. Cescon","doi":"10.20517/2394-5079.2022.71","DOIUrl":"https://doi.org/10.20517/2394-5079.2022.71","url":null,"abstract":"Intrahepatic cholangiocarcinoma (ICCA) incidence has been rising in the last few decades. Currently, hepatic resection is the only curative treatment for ICCA, and there is a lack of evidence supporting the use of preoperative treatment. A narrative review was conducted to analyze the available literature published on the role of neoadjuvant chemotherapy (CHT), either alone or combined with intra-arterial therapies (IAT), for downstaging unresectable ICCA to surgical resection. Most of the studies included in this review showed that secondary resection was associated with improvement in overall survival. In particular, studies analyzing CHT alone reported the highest conversion rate ranging from 20% to 57.1%, confirming that systemic treatment may yield the best results, and therefore, it should always be included as part of the neoadjuvant protocol. Among all the IATs, the longest overall survival reported was after CHT plus hepatic artery infusion, 25 months. Downsizing neoadjuvant multimodal approach, including combined systemic therapy with IAT, might improve the long-term outcomes of unresectable patients and expand surgical indications. However, randomized controlled trials are necessary to confirm their effectiveness.","PeriodicalId":12959,"journal":{"name":"Hepatoma Research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46396266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-13DOI: 10.20517/2394-5079.2023.23
A. Caligiuri, M. Parola, F. Marra, S. Cannito, A. Gentilini
Cholangiocarcinoma (CCA) is an extremely aggressive malignancy characterized by a very limited prognosis and scarce treatment options. The majority of patients are diagnosed at an advanced stage and do not qualify for potentially curative surgical treatments, making CCA an increasingly prevalent global challenge. CCA is characterized by a highly reactive desmoplastic stroma, with complex mechanisms underlying the mutual interactions between tumor cells and stromal compartment. This review focuses on the recent studies examining CCA’s biological features, with particular reference to the tumor reactive stroma (TRS) and its role in CCA progression, including matrix remodeling, angiogenesis and lymphangiogenesis, metastasis, and immune evasion. After giving a panoramic view of the relationship between the tumoral and stromal compartment (cancer-associated fibroblast, CAFs and tumor-associated macrophages, TAMs), this review also discusses the current therapeutic approaches to counteract CAFs and TAMs effects on CCA progression.
{"title":"Cholangiocarcinoma tumor microenvironment highlighting fibrosis and matrix components","authors":"A. Caligiuri, M. Parola, F. Marra, S. Cannito, A. Gentilini","doi":"10.20517/2394-5079.2023.23","DOIUrl":"https://doi.org/10.20517/2394-5079.2023.23","url":null,"abstract":"Cholangiocarcinoma (CCA) is an extremely aggressive malignancy characterized by a very limited prognosis and scarce treatment options. The majority of patients are diagnosed at an advanced stage and do not qualify for potentially curative surgical treatments, making CCA an increasingly prevalent global challenge. CCA is characterized by a highly reactive desmoplastic stroma, with complex mechanisms underlying the mutual interactions between tumor cells and stromal compartment. This review focuses on the recent studies examining CCA’s biological features, with particular reference to the tumor reactive stroma (TRS) and its role in CCA progression, including matrix remodeling, angiogenesis and lymphangiogenesis, metastasis, and immune evasion. After giving a panoramic view of the relationship between the tumoral and stromal compartment (cancer-associated fibroblast, CAFs and tumor-associated macrophages, TAMs), this review also discusses the current therapeutic approaches to counteract CAFs and TAMs effects on CCA progression.","PeriodicalId":12959,"journal":{"name":"Hepatoma Research","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46917087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.20517/2394-5079.2022.95
Marisa Martin, Anum Aslam, Eman Mubarak, Cate Hofley, Kayli Lala, S. Arora, D. Madoff, Elainea N. Smith, D. Owen, A. Gabr, Charles Y. Kim, N. Parikh, Erica B. Stein, Benjamin M. Mervak, Kimberly Shampain, M. Mendiratta-Lala
There are multiple liver-directed treatment options for hepatocellular carcinoma (HCC), which provide curative intent, help patients achieve remission, and/or provide a bridge to transplant by controlling local tumor progression and downstaging patients. After locoregional therapy (LRT), management of these patients, including liver transplant candidacy, is guided by treatment response assessment. The Liver Imaging Reporting and Data Systems (LI-RADS) treatment response algorithm (TRA) was created to provide a standardized assessment of HCC following LRT. Originally created primarily on expert opinion, subsequent literature has continued to evaluate the validity of this algorithm. In this manuscript, we review emerging literature supporting the use of LI-RADS in the assessment of HCC treatment response after LRT and highlight future updates.
{"title":"Imaging after liver-directed therapy: evidenced-based update of the LI-RADS treatment response algorithm","authors":"Marisa Martin, Anum Aslam, Eman Mubarak, Cate Hofley, Kayli Lala, S. Arora, D. Madoff, Elainea N. Smith, D. Owen, A. Gabr, Charles Y. Kim, N. Parikh, Erica B. Stein, Benjamin M. Mervak, Kimberly Shampain, M. Mendiratta-Lala","doi":"10.20517/2394-5079.2022.95","DOIUrl":"https://doi.org/10.20517/2394-5079.2022.95","url":null,"abstract":"There are multiple liver-directed treatment options for hepatocellular carcinoma (HCC), which provide curative intent, help patients achieve remission, and/or provide a bridge to transplant by controlling local tumor progression and downstaging patients. After locoregional therapy (LRT), management of these patients, including liver transplant candidacy, is guided by treatment response assessment. The Liver Imaging Reporting and Data Systems (LI-RADS) treatment response algorithm (TRA) was created to provide a standardized assessment of HCC following LRT. Originally created primarily on expert opinion, subsequent literature has continued to evaluate the validity of this algorithm. In this manuscript, we review emerging literature supporting the use of LI-RADS in the assessment of HCC treatment response after LRT and highlight future updates.","PeriodicalId":12959,"journal":{"name":"Hepatoma Research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67654123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.20517/2394-5079.2023.08
C. Pocha, Sabina Choudhry
Chronic liver disease is an important risk factor for the development of hepatocellular carcinoma (HCC), with 80%-90% developing in the background of cirrhosis, primarily due to alcohol abuse and chronic viral infection with hepatitis B and C. Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) related HCC is rising due to the global epidemic of obesity and diabetes. NAFLD also potentiates other risk factors of HCC, such as chronic hepatitis C and alcoholic liver injury. Furthermore, HCC may complicate non-cirrhotic NAFLD, greatly expanding the population potentially at risk. Screening and surveillance for HCC with ultrasonography (US) in this patient population pose challenges related to body habitus, liver morphology, and co-morbidities. Magnetic resonance imaging (MRI) applying various image sequence protocols and contrast agents could aid in early detection and improved prognosis of HCC. It is of utmost importance to define the most cost-effective dynamic imaging protocol for use in patients where high-quality ultrasonography images cannot be obtained and for patients undergoing surveillance for lesions identified with US. Furthermore, standardization of MRI protocols will help to define potential unique HCC features in this population. A scoring system including patient-derived factors may help to identify high-risk patients. Standardized protocols as part of prospective cohort studies and randomized clinical trials will help to stratify high-risk patients and to aid the development of professional guidelines for screening and surveillance of HCC in patients with NAFLD and NASH using dynamic imagining techniques.
{"title":"MRI for screening and surveillance for hepatocellular cancer in NAFLD and NASH","authors":"C. Pocha, Sabina Choudhry","doi":"10.20517/2394-5079.2023.08","DOIUrl":"https://doi.org/10.20517/2394-5079.2023.08","url":null,"abstract":"Chronic liver disease is an important risk factor for the development of hepatocellular carcinoma (HCC), with 80%-90% developing in the background of cirrhosis, primarily due to alcohol abuse and chronic viral infection with hepatitis B and C. Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) related HCC is rising due to the global epidemic of obesity and diabetes. NAFLD also potentiates other risk factors of HCC, such as chronic hepatitis C and alcoholic liver injury. Furthermore, HCC may complicate non-cirrhotic NAFLD, greatly expanding the population potentially at risk. Screening and surveillance for HCC with ultrasonography (US) in this patient population pose challenges related to body habitus, liver morphology, and co-morbidities. Magnetic resonance imaging (MRI) applying various image sequence protocols and contrast agents could aid in early detection and improved prognosis of HCC. It is of utmost importance to define the most cost-effective dynamic imaging protocol for use in patients where high-quality ultrasonography images cannot be obtained and for patients undergoing surveillance for lesions identified with US. Furthermore, standardization of MRI protocols will help to define potential unique HCC features in this population. A scoring system including patient-derived factors may help to identify high-risk patients. Standardized protocols as part of prospective cohort studies and randomized clinical trials will help to stratify high-risk patients and to aid the development of professional guidelines for screening and surveillance of HCC in patients with NAFLD and NASH using dynamic imagining techniques.","PeriodicalId":12959,"journal":{"name":"Hepatoma Research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67654221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.20517/2394-5079.2022.49
Kevin G. King, J. Depetris, Maitraya K Patel, S. Raman, D. Lu
The prevalence of nonalcoholic fatty liver disease (NAFLD) is increasing worldwide and is projected to become a major etiology of cirrhosis and hepatocellular carcinoma (HCC). HCC occurs more commonly in NAFLD patients who develop cirrhosis, though HCC is known to occur in the setting of noncirrhotic NAFLD as well. This is of particular importance given that the American College of Radiology (ACR) CT/MRI Liver Reporting and Data System (LI-RADS) algorithm may only be applied to a certain population of patients, and this population does not include those with noncirrhotic NAFLD. Conventional ultrasound (US) has long been in use for HCC surveillance, but contrast-enhanced US (CEUS) is a relatively newer modality, growing in use for assessment of liver lesions, and its use in HCC diagnosis has been formalized with CEUS LI-RADS. The use of US and CEUS in the assessment of liver lesions in NAFLD patients involves the consideration of certain particular nuances, and familiarity with these considerations will continue increasing in importance as the disease becomes more common.
{"title":"Contrast-enhanced ultrasound for hepatocellular carcinoma detection and diagnosis in the context of nonalcoholic fatty liver disease","authors":"Kevin G. King, J. Depetris, Maitraya K Patel, S. Raman, D. Lu","doi":"10.20517/2394-5079.2022.49","DOIUrl":"https://doi.org/10.20517/2394-5079.2022.49","url":null,"abstract":"The prevalence of nonalcoholic fatty liver disease (NAFLD) is increasing worldwide and is projected to become a major etiology of cirrhosis and hepatocellular carcinoma (HCC). HCC occurs more commonly in NAFLD patients who develop cirrhosis, though HCC is known to occur in the setting of noncirrhotic NAFLD as well. This is of particular importance given that the American College of Radiology (ACR) CT/MRI Liver Reporting and Data System (LI-RADS) algorithm may only be applied to a certain population of patients, and this population does not include those with noncirrhotic NAFLD. Conventional ultrasound (US) has long been in use for HCC surveillance, but contrast-enhanced US (CEUS) is a relatively newer modality, growing in use for assessment of liver lesions, and its use in HCC diagnosis has been formalized with CEUS LI-RADS. The use of US and CEUS in the assessment of liver lesions in NAFLD patients involves the consideration of certain particular nuances, and familiarity with these considerations will continue increasing in importance as the disease becomes more common.","PeriodicalId":12959,"journal":{"name":"Hepatoma Research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67654314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.20517/2394-5079.2023.36
F. Calderón Novoa, V. Ardiles, J. Pekolj, J. Mattera, M. de Santibañes
Intrahepatic cholangiocarcinoma (iCCA) is a rare tumor that arises from second order or smaller bile ducts. Its incidence has been growing in the last couple of decades, in parallel with its mortality rates, both in America and Europe. The currently accepted gold treatment for iCCA is liver resection (LR). However, results are still poor, with 5-year survival rates ranging between 25% and 40%. In addition, more than half of the patients undergoing LR will relapse, particularly those who present with multifocal iCCA. Given the aggressiveness of this tumor, and the modest results seen with adjuvant and neoadjuvant therapies, the sights have been set on liver transplantation (LT) for this disease. Retrospective studies have shown encouraging results in select patients, especially those with very early-staged iCCA (< 2 cm) who underwent LT. The aim of this review is to analyze the current information regarding LT for iCCA, as well as future perspectives.
{"title":"Liver transplantation for intrahepatic cholangiocarcinoma: a narrative review of the latest advances","authors":"F. Calderón Novoa, V. Ardiles, J. Pekolj, J. Mattera, M. de Santibañes","doi":"10.20517/2394-5079.2023.36","DOIUrl":"https://doi.org/10.20517/2394-5079.2023.36","url":null,"abstract":"Intrahepatic cholangiocarcinoma (iCCA) is a rare tumor that arises from second order or smaller bile ducts. Its incidence has been growing in the last couple of decades, in parallel with its mortality rates, both in America and Europe. The currently accepted gold treatment for iCCA is liver resection (LR). However, results are still poor, with 5-year survival rates ranging between 25% and 40%. In addition, more than half of the patients undergoing LR will relapse, particularly those who present with multifocal iCCA. Given the aggressiveness of this tumor, and the modest results seen with adjuvant and neoadjuvant therapies, the sights have been set on liver transplantation (LT) for this disease. Retrospective studies have shown encouraging results in select patients, especially those with very early-staged iCCA (< 2 cm) who underwent LT. The aim of this review is to analyze the current information regarding LT for iCCA, as well as future perspectives.","PeriodicalId":12959,"journal":{"name":"Hepatoma Research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67654482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-01-01DOI: 10.20517/2394-5079.2023.37
Sara Young, R. Sritharan, D. Sia
Intrahepatic cholangiocarcinoma (iCCA) is an aggressive and heterogeneous biliary cancer with a poor prognosis and limited treatment options. The molecular pathogenesis of iCCA involves a highly complex process entailing multiple genetic alterations and dysregulation of signaling pathways. Recent advancements in our understanding of the genetic landscape of iCCA have opened new opportunities for therapeutic interventions. Technologies such as next-generation sequencing (NGS) have contributed to elucidating the genetic heterogeneity of iCCA, leading to the identification of numerous potentially actionable genetic alterations. Despite these advances, the prognosis of iCCA patients remains dismal. In this review, we provide an extensive summary of the current knowledge on genetic alterations in iCCA, their biological impact on patients, potential therapeutic targets, approved targeted therapies, and ongoing clinical trials with targeted agents. Furthermore, we discuss the main technologies available for studying genetic alterations and their advantages and limitations. Finally, we highlight future directions in studying genetic alterations and the development of new targeted therapies and personalized medicine approaches.
{"title":"Genomic alterations in intrahepatic cholangiocarcinoma","authors":"Sara Young, R. Sritharan, D. Sia","doi":"10.20517/2394-5079.2023.37","DOIUrl":"https://doi.org/10.20517/2394-5079.2023.37","url":null,"abstract":"Intrahepatic cholangiocarcinoma (iCCA) is an aggressive and heterogeneous biliary cancer with a poor prognosis and limited treatment options. The molecular pathogenesis of iCCA involves a highly complex process entailing multiple genetic alterations and dysregulation of signaling pathways. Recent advancements in our understanding of the genetic landscape of iCCA have opened new opportunities for therapeutic interventions. Technologies such as next-generation sequencing (NGS) have contributed to elucidating the genetic heterogeneity of iCCA, leading to the identification of numerous potentially actionable genetic alterations. Despite these advances, the prognosis of iCCA patients remains dismal. In this review, we provide an extensive summary of the current knowledge on genetic alterations in iCCA, their biological impact on patients, potential therapeutic targets, approved targeted therapies, and ongoing clinical trials with targeted agents. Furthermore, we discuss the main technologies available for studying genetic alterations and their advantages and limitations. Finally, we highlight future directions in studying genetic alterations and the development of new targeted therapies and personalized medicine approaches.","PeriodicalId":12959,"journal":{"name":"Hepatoma Research","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67654493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：