Geynisman Daniel M, Catenacci Daniel V T
Section of Hematology/Oncology, Department of Medicine, University of Chicago Medical Center, Chicago, Illinois 60637, USA.
Discov Med. 2012 Jul;14(74):41-57.
Biliary tract cancers (BTC) are a relatively rare heterogeneous group of four to five anatomically distinct cancers whose prognosis is poor, even in the setting of attempted curative resection. Curative resection, in itself, is much less common than locally advanced unresectable and/or overt metastatic disease at presentation. Standard chemotherapy options are generally palliative for advanced BTC (aBTC), and recently the combination of gemcitabine with cisplatin has emerged as the standard-of-care providing a median overall survival of approximately one year. A movement toward molecularly based personalized cancer therapy has occurred in recent years, including for aBTC, with a number of pathways emerging as putative therapeutic targets. This review will briefly summarize the epidemiology, etiology, and general prognosis of BTC, then discuss the data supporting current standard cytotoxic treatments of aBTC, and proceed to focus on the molecular features of this heterogeneous set of diseases. Finally, we review strategies which will potentially improve our ability to individualize therapy and, ultimately, clinical outcomes in the future.
胆道癌（BTC）是一组相对罕见的异质性癌症，包括四到五种在解剖学上不同的癌症，其预后较差，即使在尝试进行根治性切除的情况下也是如此。根治性切除本身在就诊时比局部晚期不可切除和/或明显转移性疾病要少见得多。标准化疗方案通常用于晚期BTC（aBTC）的姑息治疗，最近吉西他滨与顺铂联合使用已成为标准治疗方案，可提供约一年的中位总生存期。近年来，包括aBTC在内，已经出现了向基于分子的个性化癌症治疗的转变，一些途径已成为公认的治疗靶点。本综述将简要总结BTC的流行病学、病因和一般预后，然后讨论支持当前aBTC标准细胞毒性治疗的数据，并进而关注这组异质性疾病的分子特征。最后，我们回顾了可能提高我们未来个性化治疗能力并最终改善临床结果的策略。
