Immunotherapy: A Sharp Curve Turn at the Corner of Targeted Therapy in the Treatment of Biliary Tract Cancers

Hematol Oncol Clin North Am. 2024 Jun;38(3):643-657. doi: 10.1016/j.hoc.2024.01.005. Epub 2024 Feb 28.

Abstract

Biliary tract cancers continue to increase in incidence and have a high mortality rate. Most of the patients present with advanced-stage disease. The discovery of targetable genomic alterations addressing IDH, FGFR, HER2, BRAFV600 E, and others has led to the identification and validation of novel therapies in biliary cancer. Recent advances demonstrating an improved outcome with the addition of immune checkpoint inhibitors to chemotherapy have established a new first-line care standard. In case of contraindications to the use of checkpoint inhibitors and the absence of targetable alterations, chemotherapy remains to be the standard of care.

Keywords: Biliary tract cancers; Cholangiocarcinoma; Cytotoxic chemotherapy; Gallbladder cancer; Immune checkpoint inhibitors; Precision medicine; Targeted therapy.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biliary Tract Neoplasms* / drug therapy
  • Biliary Tract Neoplasms* / genetics
  • Biliary Tract Neoplasms* / immunology
  • Biliary Tract Neoplasms* / therapy
  • Humans
  • Immune Checkpoint Inhibitors* / therapeutic use
  • Immunotherapy* / methods
  • Molecular Targeted Therapy* / methods

Substances

  • Immune Checkpoint Inhibitors