A Practical Guide for the Systemic Treatment of Biliary Tract Cancer in Canada

Autor: Ravi Ramjeesingh, Prosanto Chaudhury, Vincent C. Tam, David Roberge, Howard J. Lim, Jennifer J. Knox, Jamil Asselah, Sarah Doucette, Nirlep Chhiber, Rachel Goodwin
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Current Oncology, Vol 30, Iss 8, Pp 7132-7150 (2023)
Druh dokumentu: article
ISSN: 30080517
1718-7729
1198-0052
DOI: 10.3390/curroncol30080517
Popis: Biliary tract cancers (BTC) are rare and aggressive tumors with poor prognosis. Radical surgery offers the best chance for cure; however, most patients present with unresectable disease, and among those receiving curative-intent surgery, recurrence rates remain high. While other locoregional therapies for unresectable disease may be considered, only select patients may be eligible. Consequently, systemic therapy plays a significant role in the treatment of BTC. In the adjuvant setting, capecitabine is recommended following curative-intent resection. In the neoadjuvant setting, systemic therapy has mostly been explored for downstaging in borderline resectable tumours, although evidence for its routine use is lacking. For advanced unresectable or metastatic disease, gemcitabine-cisplatin plus durvalumab has become the standard of care, while the addition of pembrolizumab to gemcitabine-cisplatin has also recently demonstrated improved survival compared to chemotherapy alone. Following progression on gemcitabine-cisplatin, several chemotherapy combinations and biomarker-driven targeted agents have been explored. However, the optimum regimen remains unclear, and access to targeted agents remains challenging in Canada. Overall, this article serves as a practical guide for the systemic treatment of BTC in Canada, providing valuable insights into the current and future treatment landscape for this challenging disease.
Databáze: Directory of Open Access Journals
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