Cholangiocarcinoma - novel biological insights and therapeutic strategies
Affiliation
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USAIssue Date
2023
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In the past 5 years, important advances have been made in the scientific understanding and clinical management of cholangiocarcinoma (CCA). The cellular immune landscape of CCA has been characterized and tumour subsets with distinct immune microenvironments have been defined using molecular approaches. Among these subsets, the identification of 'immune-desert' tumours that are relatively devoid of immune cells emphasizes the need to consider the tumour immune microenvironment in the development of immunotherapy approaches. Progress has also made in identifying the complex heterogeneity and diverse functions of cancer-associated fibroblasts in this desmoplastic cancer. Assays measuring circulating cell-free DNA and cell-free tumour DNA are emerging as clinical tools for detection and monitoring of the disease. Molecularly targeted therapy for CCA has now become a reality, with three drugs targeting oncogenic fibroblast growth factor receptor 2 (FGFR2) fusions and one targeting neomorphic, gain-of-function variants of isocitrate dehydrogenase 1 (IDH1) obtaining regulatory approval. By contrast, immunotherapy using immune-checkpoint inhibitors has produced disappointing results in patients with CCA, underscoring the requirement for novel immune-based treatment strategies. Finally, liver transplantation for early stage intrahepatic CCA under research protocols is emerging as a viable therapeutic option in selected patients. This Review highlights and provides in-depth information on these advances.Citation
Ilyas SI, Affo S, Goyal L, Lamarca A, Sapisochin G, Yang JD, et al. Cholangiocarcinoma - novel biological insights and therapeutic strategies. Nature reviews Clinical oncology. 2023 May 15. PubMed PMID: 37188899. Epub 2023/05/16. eng.Journal
Nature Reviews Clinical OncologyDOI
10.1038/s41571-023-00770-1PubMed ID
37188899Additional Links
https://dx.doi.org/10.1038/s41571-023-00770-1Type
ArticleLanguage
enae974a485f413a2113503eed53cd6c53
10.1038/s41571-023-00770-1