Biliary Tract Cancers: Molecular Heterogeneity and New Treatment Options.
Biliary Tract Cancers: Molecular Heterogeneity and New Treatment Options.
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DOI：
10.3390/cancers12113370
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发表时间：
2020-11-13
期刊：
影响因子：
5.2
通讯作者：
Rimassa L
中科院分区：
文献类型：
--
作者：
Personeni N;Lleo A;Pressiani T;Colapietro F;Openshaw MR;Stavraka C;Pouptsis A;Pinato DJ;Rimassa L
胆道癌的发病率正在增加，当治疗选择有限时，患者经常被诊断为不可切除或转移性疾病。由于这些原因，预后仍然很差，迫切需要新的系统治疗方案。本文综述了胆管癌，特别是肝内胆管癌的分子异质性的新的可用数据和新的治疗策略提供了这种疾病的生物学知识的提高。由于这些原因，该主题对肿瘤学和肝病学社区具有相关意义。大多数胆道癌（BTC）患者被诊断为晚期疾病，在接受手术的患者中复发率高，预后仍然很差，而发病率正在增加。治疗选择有限，化疗仍然是辅助和晚期疾病背景下的标准治疗。近年来，BTC的不同亚型已根据解剖位置和遗传和/或表观遗传畸变定义。特别是对于肝内胆管癌（iCCA），已经确定了新的治疗靶点，包括成纤维细胞生长因子受体2基因融合和异柠檬酸脱氢酶1和2突变，分子靶向药物在该亚组患者中显示出活性的证据。此外，在iCCA和BTC的其他亚型中，正在评估其他途径，以及免疫微环境的靶向。对BTC生物学和分子异质性的不断了解为开发新的治疗方法铺平了道路，这些方法将在不久的将来完全改变这种疾病的治疗模式。本文综述了BTC的分子异质性，并总结了开发中的新靶点和新兴疗法。我们还讨论了BTC管理的阻力机制，开放问题和未来前景。
Incidence of biliary tract cancer is increasing, and patients are frequently diagnosed with unresectable or metastatic disease, when therapeutic options are limited. Due to these reasons, prognosis remains poor and new systemic treatment options are urgently needed. This article reviews the new available data on molecular heterogeneity of biliary tract cancer and especially intrahepatic cholangiocarcinoma and the novel therapeutic strategies offered by the improved knowledge of the biology of this disease. For these reasons, this topic is of relevant interest for the oncology and hepatology community. Most patients with biliary tract cancer (BTC) are diagnosed with advanced disease, relapse rates are high in those undergoing surgery and prognosis remains poor, while the incidence is increasing. Treatment options are limited, and chemotherapy is still the standard of care in both adjuvant and advanced disease setting. In recent years, different subtypes of BTC have been defined depending on the anatomical location and genetic and/or epigenetic aberrations. Especially for intrahepatic cholangiocarcinoma (iCCA) novel therapeutic targets have been identified, including fibroblast growth factor receptor 2 gene fusions and isocitrate dehydrogenase 1 and 2 mutations, with molecularly targeted agents having shown evidence of activity in this subgroup of patients. Additionally, other pathways are being evaluated in both iCCA and other subtypes of BTC, alongside targeting of the immune microenvironment. The growing knowledge of BTC biology and molecular heterogeneity has paved the way for the development of new therapeutic approaches that will completely change the treatment paradigm for this disease in the near future. This review provides an overview of the molecular heterogeneity of BTC and summarizes new targets and emerging therapies in development. We also discuss resistance mechanisms, open issues, and future perspectives in the management of BTC.
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影响因子：
7.2
作者：
Belov AA;Mohammadi M
通讯作者：
Mohammadi M
DOI：
10.1016/s1470-2045(20)30157-1
发表时间：
2020-06
期刊：
The Lancet. Oncology
影响因子：
--
作者：
Abou-Alfa GK;Macarulla T;Javle MM;Kelley RK;Lubner SJ;Adeva J;Cleary JM;Catenacci DV;Borad MJ;Bridgewater J;Harris WP;Murphy AG;Oh DY;Whisenant J;Lowery MA;Goyal L;Shroff RT;El-Khoueiry AB;Fan B;Wu B;Chamberlain CX;Jiang L;Gliser C;Pandya SS;Valle JW;Zhu AX
通讯作者：
Zhu AX
影响因子：
4.6
作者：
Bustos, Bernabe I.;Perez-Palma, Eduardo;Francisco Miquel, Juan
通讯作者：
Francisco Miquel, Juan
影响因子：
3.3
作者：
Eckel, Florian;Schmid, Roland M.
通讯作者：
Schmid, Roland M.
影响因子：
8.8
作者：
Andre, T.;Reyes-Vidal, J. M.;Fartoux, L.;Ross, P.;Leslie, M.;Rosmorduc, O.;Clemens, M. R.;Louvet, C.;Perez, N.;Mehmud, F.;Scheithauer, W.
通讯作者：
Scheithauer, W.