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dc.contributor.authorValle, Juan W
dc.contributor.authorLamarca, Angela
dc.contributor.authorGoyal, L
dc.contributor.authorBarriuso, Jorge
dc.contributor.authorZhu, A
dc.date.accessioned2017-09-06T12:51:21Z
dc.date.available2017-09-06T12:51:21Z
dc.date.issued2017-08-17
dc.identifier.citationNew horizons for precision medicine in biliary tract cancers. 2017 Cancer Discoven
dc.identifier.issn2159-8290
dc.identifier.pmid28818953
dc.identifier.doi10.1158/2159-8290.CD-17-0245
dc.identifier.urihttp://hdl.handle.net/10541/620530
dc.description.abstractBiliary tract cancers (BTC), including cholangiocarcinoma and gallbladder cancer, are poor-prognosis and low-incidence cancers, although the incidence of intrahepatic cholangiocarcinoma is rising. A minority of patients present with resectable disease but relapse rates are high; benefit from adjuvant capecitabine chemotherapy has been demonstrated. Cisplatin/gemcitabine combination chemotherapy has emerged as the reference first-line treatment regimen; there is no standard second-line therapy. Selected patients may be suitable for liver-directed therapy (e.g., radioembolization or external beam radiation), pending confirmation of benefit in randomized studies. Initial trials targeting the epithelial growth factor receptor and angiogenesis pathways have failed to deliver new treatments. Emerging data from next-generation sequencing analyses have identified actionable mutations (e.g., FGFR fusion rearrangements and IDH1 and IDH2 mutations), with several targeted drugs entering clinical development with encouraging results. The role of systemic therapies, including targeted therapies and immunotherapy for BTC, is rapidly evolving and is the subject of this review.Significance: The authors address genetic drivers and molecular biology from a translational perspective, in an intent to offer a clear view of the recent past, present, and future of BTC. The review describes a state-of-the-art update of the current status and future directions of research and therapy in advanced BTC. Cancer Discov; 7(9); 1-20. ©2017 AACR.
dc.language.isoenen
dc.publisherDepartment of Medical Oncology, The Christie NHS Foundation Trust, Wilmslow Road, Manchester, UKen
dc.rightsArchived with thanks to Cancer discoveryen
dc.titleNew horizons for precision medicine in biliary tract cancers.en
dc.typeArticleen
dc.identifier.journalCancer Discoveryen
refterms.dateFOA2020-04-27T12:37:51Z
html.description.abstractBiliary tract cancers (BTC), including cholangiocarcinoma and gallbladder cancer, are poor-prognosis and low-incidence cancers, although the incidence of intrahepatic cholangiocarcinoma is rising. A minority of patients present with resectable disease but relapse rates are high; benefit from adjuvant capecitabine chemotherapy has been demonstrated. Cisplatin/gemcitabine combination chemotherapy has emerged as the reference first-line treatment regimen; there is no standard second-line therapy. Selected patients may be suitable for liver-directed therapy (e.g., radioembolization or external beam radiation), pending confirmation of benefit in randomized studies. Initial trials targeting the epithelial growth factor receptor and angiogenesis pathways have failed to deliver new treatments. Emerging data from next-generation sequencing analyses have identified actionable mutations (e.g., FGFR fusion rearrangements and IDH1 and IDH2 mutations), with several targeted drugs entering clinical development with encouraging results. The role of systemic therapies, including targeted therapies and immunotherapy for BTC, is rapidly evolving and is the subject of this review.Significance: The authors address genetic drivers and molecular biology from a translational perspective, in an intent to offer a clear view of the recent past, present, and future of BTC. The review describes a state-of-the-art update of the current status and future directions of research and therapy in advanced BTC. Cancer Discov; 7(9); 1-20. ©2017 AACR.


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