Biliary Tract Cancer: Implicated Immune-Mediated Pathways and Their Associated Potential Targets

Oncol Res Treat. 2018;41(5):298-304. doi: 10.1159/000488997. Epub 2018 Apr 26.

Abstract

There is a well-established link between biliary tract cancers (BTC) and chronic inflammatory conditions such as primary sclerosing cholangitis, chronic cholecystitis, chronic cholelithiasis, liver fluke-associated infestations, and chronic viral hepatic infections. These associated risk factors highlight the potential for development of immune-modulatory agents in this poor-prognostic disease group with limited treatment options. Clinical trials have evaluated the role of immune cells, inflammatory biomarkers, vaccines, cytokines, adoptive cell therapy, and immune checkpoint inhibitors in patients with BTC. Although these have demonstrated the importance of the immune environment in BTC, currently none of the immune-based therapies have been approved for use in this disease group. The role of immunomodulatory agents is a developing field and has yet to find its way 'from bench to bedside' in BTC.

Keywords: Biliary tract cancer; Immune checkpoint inhibitors; Immunotherapy.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents, Immunological / pharmacology
  • Antineoplastic Agents, Immunological / therapeutic use
  • Biliary Tract Neoplasms / immunology
  • Biliary Tract Neoplasms / pathology
  • Biliary Tract Neoplasms / therapy*
  • Cancer Vaccines / therapeutic use
  • Carcinogenesis / immunology*
  • Carcinogenesis / pathology
  • Cholangitis, Sclerosing / immunology
  • Cholangitis, Sclerosing / pathology
  • Cholecystitis / immunology
  • Cholecystitis / pathology
  • Cholelithiasis / immunology
  • Cholelithiasis / pathology
  • Costimulatory and Inhibitory T-Cell Receptors / antagonists & inhibitors
  • Costimulatory and Inhibitory T-Cell Receptors / immunology
  • Costimulatory and Inhibitory T-Cell Receptors / metabolism
  • Disease Progression
  • Hepatitis, Chronic / immunology
  • Hepatitis, Chronic / pathology
  • Humans
  • Immunotherapy / methods*
  • Molecular Targeted Therapy / methods
  • Signal Transduction / drug effects
  • Signal Transduction / immunology
  • Tumor Microenvironment / immunology*

Substances

  • Antineoplastic Agents, Immunological
  • Cancer Vaccines
  • Costimulatory and Inhibitory T-Cell Receptors