College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
Saskatoon Cancer Center, Saskatchewan Cancer Agency, University of Saskatchewan, Saskatoon, SK, Canada.
J Hepatobiliary Pancreat Sci. 2022 Oct;29(10):1094-1107. doi: 10.1002/jhbp.939. Epub 2021 Apr 5.
Biliary tract cancers (BTCs) are heterogeneous cancers that include cancers of the bile duct and gallbladder. Although they are relatively uncommon, most patients with BTC are diagnosed at advanced-stage disease with high mortality rates. Recently, systemic therapy options for patients with BTC have evolved. This paper reviews recent advancements in systemic therapy and the results of key clinical trials in BTC.
A literature search in PubMed and Google Scholar was performed using keywords related to BTC and systemic therapy. Studies that were presented in major international cancer research conferences were also included.
The evidence shows that adjuvant capecitabine has been associated with a lower relapse rate in early-stage BTC. In unselected patients with advanced BTC, combination chemotherapy is a standard treatment option. However, with a better understanding of the molecular profile of BTC, there has been a shift toward targeted agents in BTC that have shown promising responses. The evolving data also support the evolving role of immunotherapy in patients with deficient DNA mismatch repair or PD-L1-positive BTC.
Systemic treatment options for BTC have improved. The future identification of new targets, novel compounds, and predictive markers is a key step toward the use of personalized medicine in BTC.
胆道癌（BTC）是一种异质性癌症，包括胆管癌和胆囊癌。尽管它们相对少见，但大多数 BTC 患者在诊断时已处于晚期，死亡率较高。最近，BTC 患者的系统治疗选择已经发展。本文综述了 BTC 系统治疗的最新进展和关键临床试验的结果。
在 PubMed 和 Google Scholar 上使用与 BTC 和系统治疗相关的关键词进行文献检索。还包括在主要国际癌症研究会议上发表的研究。
证据表明，辅助卡培他滨与早期 BTC 较低的复发率相关。在未选择的晚期 BTC 患者中，联合化疗是标准的治疗选择。然而，随着对 BTC 分子谱的更好理解，针对 BTC 的靶向药物已经发生转变，显示出有希望的反应。不断发展的数据还支持免疫疗法在存在 DNA 错配修复缺陷或 PD-L1 阳性 BTC 的患者中的作用不断发展。
BTC 的系统治疗选择有所改善。未来确定新的靶点、新化合物和预测标志物是在 BTC 中使用个性化医学的关键步骤。
