Wang Jiayi, Liu Siyan, Cao Yi, Chen Yong
International Medical College, Chongqing Medical University, Chongqing, China.
Second Clinical College, Chongqing Medical University, Chongqing, China.
Front Cell Dev Biol. 2024 Aug 2;12:1408852. doi: 10.3389/fcell.2024.1408852. eCollection 2024.
Significant advancements in our understanding and clinical treatment of cholangiocarcinoma (CCA) have been achieved over the past 5 years. Groundbreaking studies have illuminated the immune landscape and pathological characteristics of the tumor microenvironment in CCA. The development of immune- and metabolism-based classification systems has enabled a nuanced exploration of the tumor microenvironment and the origins of CCA, facilitating a detailed understanding of tumor progression modulation. Despite these insights, targeted therapies have not yet yielded satisfactory clinical results, highlighting the urgent need for innovative therapeutic strategies. This review delineates the complexity and heterogeneity of CCA, examines the current landscape of therapeutic strategies and clinical trials, and delves into the resistance mechanisms underlying targeted therapies. Finally, from a single-cell and spatial transcriptomic perspective, we address the challenge of therapy resistance, discussing emerging mechanisms and potential strategies to overcome this barrier and enhance treatment efficacy.
在过去5年里，我们对胆管癌（CCA）的理解和临床治疗取得了重大进展。开创性研究揭示了CCA肿瘤微环境的免疫格局和病理特征。基于免疫和代谢的分类系统的发展，使得对肿瘤微环境和CCA起源进行细致入微的探索成为可能，有助于深入了解肿瘤进展的调控机制。尽管有这些见解，但靶向治疗尚未取得令人满意的临床结果，这凸显了对创新治疗策略的迫切需求。本综述阐述了CCA的复杂性和异质性，审视了当前治疗策略和临床试验的现状，并深入探讨了靶向治疗的耐药机制。最后，从单细胞和空间转录组学的角度，我们应对治疗耐药性的挑战，讨论新出现的机制以及克服这一障碍和提高治疗效果的潜在策略。
