Adjuvant chemotherapy in biliary tract cancer: state of the art and future perspectives
Affiliation
Department of Medical Oncology and Hematology, University Hospital Zurich, Zurich, Switzerland.Issue Date
2020
Metadata
Show full item recordAbstract
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
Akhoundova Sanoyan D, McNamara MG, Lamarca A, Valle JW. Adjuvant chemotherapy in biliary tract cancer: state of the art and future perspectives. Curr Opin Oncol. 2020;32(4):364-9.Journal
Current Opinion in OncologyDOI
10.1097/cco.0000000000000643PubMed ID
32541326Additional Links
https://dx.doi.org/10.1097/cco.0000000000000643Type
ArticleLanguage
enae974a485f413a2113503eed53cd6c53
10.1097/cco.0000000000000643
Scopus Count
Collections
Related articles
- Gemcitabine-based chemotherapy for advanced biliary tract carcinomas.
- Authors: Abdel-Rahman O, Elsayed Z, Elhalawani H
- Issue date: 2018 Apr 6
- Adjuvant and neoadjuvant therapy for biliary tract cancer: a review of clinical trials.
- Authors: Nara S, Esaki M, Ban D, Takamoto T, Shimada K, Ioka T, Okusaka T, Ishii H, Furuse J
- Issue date: 2020 Dec 16
- Current standards and future perspectives in adjuvant treatment for biliary tract cancers.
- Authors: Lamarca A, Edeline J, McNamara MG, Hubner RA, Nagino M, Bridgewater J, Primrose J, Valle JW
- Issue date: 2020 Mar
- Adjuvant systemic treatment in resected biliary tract cancer: State of the art, controversies, and future directions.
- Authors: Rizzo A, Brandi G
- Issue date: 2021
- Gemcitabine-based versus fluoropyrimidine-based chemotherapy with or without platinum in unresectable biliary tract cancer: a retrospective study.
- Authors: Kim MJ, Oh DY, Lee SH, Kim DW, Im SA, Kim TY, Heo DS, Bang YJ
- Issue date: 2008 Dec 18