Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi University Hospital, Bologna, Italy
Department of Experimental, Diagnostic and Specialty Medicine, S. Orsola-Malpighi University Hospital, Bologna, Italy.
Anticancer Res. 2020 Jun;40(6):3013-3030. doi: 10.21873/anticanres.14282.
Biliary tract cancer (BTC) patients usually have poor prognosis. Whereas combination chemotherapy has been shown to improve survival in the frontline setting, second-line treatment is subject to a lot of debate in the scientific community. Recent data of the ABC-06 trial has provided slight evidence for the use of second-line chemotherapy after progression on cisplatin plus gemcitabine combination. In this study, mFOLFOX plus active symptom control (ASC) improved overall survival (OS) after progression on cisplatin-gemcitabine combination compared with ASC alone, with an increase in 6- and 12-month OS rate. Although genomic studies have paved the way for a new age in cancer management, the "Precision Medicine Era" in BTC is still limited to intrahepatic cholangiocarcinoma and primarily focused on isocitrate dehydrogenase (IDH) and fibroblast growth factor receptor (FGFR) targeted therapies. We herein review recent published data regarding the use of second-line treatment after failure of standard first-line therapies in BTC patients, with a particular focus on ongoing active and recruiting clinical trials.
胆道癌（BTC）患者的预后通常较差。虽然联合化疗已被证明可改善一线治疗中的生存情况，但二线治疗在科学界仍存在诸多争议。ABC-06 试验的最新数据为顺铂加吉西他滨联合治疗进展后的二线化疗提供了一些证据。在这项研究中，与单独接受 ASC 治疗相比，mFOLFOX 联合积极症状控制（ASC）治疗在顺铂-吉西他滨联合治疗进展后的总生存期（OS）得到改善，6 个月和 12 个月的 OS 率增加。尽管基因组研究为癌症管理的新时代铺平了道路，但 BTC 的“精准医学时代”仍仅限于肝内胆管癌，主要集中在异柠檬酸脱氢酶（IDH）和成纤维细胞生长因子受体（FGFR）靶向治疗上。本文综述了最近发表的关于 BTC 患者标准一线治疗失败后二线治疗的应用数据，特别关注正在进行的积极和招募中的临床试验。
