Development of possible next line of systemic therapies for gemcitabine-resistant biliary tract cancers: A perspective from clinical trials

Nai Jung Chiang, Li Tzong Chen, Yan Shen Shan, Chun Nan Yeh, Ming Huang Chen

研究成果: Review article同行評審

摘要

Biliary tract cancer (BTC) compromises a heterogenous group of tumors with poor prognoses. Curative surgery remains the first choice for localized disease; however, most BTC patients have had unresectable or metastatic disease. The gold standard therapy for these patients is chemotherapy with gemcitabine and cisplatin. There are no consensus guidelines for standard treatment in a second-line setting, although the data of the ABC-06 trial showed a slight survival benefit from oxaliplatin and 5-fluorouracil combination chemotherapy. Recent progress in comprehensive genomic profiling for advanced BTC (ABTC) has helped to clarify tumorigenesis and facilitate the coming era of precision medicine. Generally, targeted agents fail to show significant clinical benefits in unselected populations. Only fibroblast growth factor receptor 2 (FGFR2) fusion and isocitrate dehydrogenase (IDH)-and BRAF mutation-enriched populations have survival benefits from the corresponding inhibitors. Several interesting targeted agents for monotherapies or combination therapies with other compounds are currently ongoing or recruiting. Here, we review the published data from clinical trials of second-line therapies after the failure of gemcitabine-based chemotherapy in ABTC. The results were stratified by different genetic alternations, as well as by chemotherapy, targeted therapy and immunotherapy.

原文English
文章編號97
頁(從 - 到)1-20
頁數20
期刊Biomolecules
11
發行號1
DOIs
出版狀態Published - 2021 一月

All Science Journal Classification (ASJC) codes

  • Biochemistry
  • Molecular Biology

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