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    Adjuvant chemotherapy in biliary tract cancer: state of the art and future perspectives

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    Authors
    Sanoyan, D. A.
    McNamara, Mairead G
    Lamarca, Angela
    Valle, Juan W
    Affiliation
    Department of Medical Oncology and Hematology, University Hospital Zurich, Zurich, Switzerland.
    Issue Date
    2020
    
    Metadata
    Show full item record
    Abstract
    PURPOSE OF REVIEW: Biliary tract cancers (BTCs) have a poor prognosis; most patients present with advanced disease and, even after surgical resection for early-stage disease local and distant relapses are frequent. Involved resection margins and lymph node involvement are the most relevant known adverse prognostic factors. Historically clinicians have made clinical decisions based on data from institutional series and uncontrolled studies, with their inherent limitations. In this review, data from recently-reported prospective randomized trials are reviewed and clinical implications discussed. RECENT FINDINGS: Results from prospective randomized phase III trials (namely BILCAP, PRODIGE-12, and BCAT) are reviewed: none of the studies met their primary endpoint by intention-to-treat analysis. However, following a per-protocol sensitivity analysis of the BILCAP study, adjuvant capecitabine (for 6 months) showed a clinically-relevant improvement in overall survival and provides reference data for future clinical trials. SUMMARY: Adjuvant chemotherapy with capecitabine should be considered following curative resection of BTC. Identification of benefit in anatomical subgroups is ongoing and future trials should also consider the implication of molecular subtypes of BTC (for prognostic impact and on-target therapeutic options).
    Citation
    D. A. Sanoyan, M. G. McNamara, A. Lamarca and J. W. Valle. Adjuvant chemotherapy in biliary tract cancer: state of the art and future perspectives. Curr Opin Oncol. 2020.
    Journal
    Current Opinion in Oncology
    URI
    http://hdl.handle.net/10541/623020
    DOI
    10.1097/cco.0000000000000643
    PubMed ID
    32412976
    Additional Links
    https://dx.doi.org/10.1097/cco.0000000000000643
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1097/cco.0000000000000643
    Scopus Count
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