New Horizons for Precision Medicine in Biliary Tract Cancers

摘要: Biliary tract cancers (BTC), including cholangiocarcinoma and gallbladder cancer, are poor-prognosis low-incidence cancers, although the incidence of intrahepatic is rising. A minority patients present with resectable disease but relapse rates high; benefit from adjuvant capecitabine chemotherapy has been demonstrated. Cisplatin/gemcitabine combination emerged as reference first-line treatment regimen; there no standard second-line therapy. Selected may be suitable for liver-directed therapy (e.g., radioembolization or external beam radiation), pending confirmation in randomized studies. Initial trials targeting epithelial growth factor receptor angiogenesis pathways have failed to deliver new treatments. Emerging data next-generation sequencing analyses identified actionable mutations FGFR fusion rearrangements IDH1 IDH2 mutations), several targeted drugs entering clinical development encouraging results. The role systemic therapies, therapies immunotherapy BTC, rapidly evolving subject this review.Significance: authors address genetic drivers molecular biology a translational perspective, an intent offer clear view recent past, present, future BTC. review describes state-of-the-art update current status directions research advanced Cancer Discov; 7(9); 943-62. ©2017 AACR.