Fiche publication
Date publication
juin 2020
Journal
Clinics and research in hepatology and gastroenterology
Auteurs
Membres identifiés du Cancéropôle Est :
Dr VIENOT Angélique
Tous les auteurs :
Vienot A, Neuzillet C
Lien Pubmed
Résumé
Biliary tract cancers (BTC) are a heterogeneous group of epithelial neoplasms, with a poor prognosis. Advanced BTC remains a challenging, non-curable disease. In this review, we provide an overview of the medical treatment options in advanced BTC and new strategies under development. Gemcitabine plus platinum chemotherapy is the standard first-line therapy in this setting. Recently, 5-fluorouracil, folinic acid plus oxaliplatin (FOLFOX) regimen became the only second-line therapy to be prospectively validated beyond failure of gemcitabine plus cisplatin combination in a phase III study, even though chemotherapy yielded modest survival improvement over best supportive care. Anti-epidermal growth factor receptor and antiangiogenic antibodies have not demonstrated any survival benefit in unselected patient populations. In recent years, knowledge about the molecular heterogeneity of BTC has considerably increased with the advent of large-scale genomic and transcriptomic analyses, opening up new perspectives for so-called personalised targeted therapies. Patients with BTC may be particularly good candidates for biomarker-driven strategies in clinical practice. Among current developments, the targeting of fibroblast growth factor receptor and isocitrate dehydrogenase gene alterations are the most promising avenues, and combination immunotherapies are under investigation.
Mots clés
Biliary tract cancer, Chemotherapy, Fibroblast growth factor receptor, Immune therapy, Isocitrate dehydrogenase
Référence
Clin Res Hepatol Gastroenterol. 2020 Jun 22;:
