Clinical treatment of cholangiocarcinoma: an updated comprehensive review
Cholangiocarcinoma (CCA) is a heterogeneous group of neoplasms of the bile ducts and represents the second most common hepatic cancer after hepatocellular carcinoma; it is sub-classified as intrahepatic cholangiocarcinoma (iCCA) and extrahepatic cholangiocarcinoma (eCCA), the latter comprising both...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-09-01
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| Series: | Annals of Hepatology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1665268122000795 |
| _version_ | 1811188064888815616 |
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| author | Alessandra Elvevi Alice Laffusa Miki Scaravaglio Roberta Elisa Rossi Raffaella Longarini Anna Maria Stagno Laura Cristoferi Antonio Ciaccio Diego Luigi Cortinovis Pietro Invernizzi Sara Massironi |
| author_facet | Alessandra Elvevi Alice Laffusa Miki Scaravaglio Roberta Elisa Rossi Raffaella Longarini Anna Maria Stagno Laura Cristoferi Antonio Ciaccio Diego Luigi Cortinovis Pietro Invernizzi Sara Massironi |
| author_sort | Alessandra Elvevi |
| collection | DOAJ |
| description | Cholangiocarcinoma (CCA) is a heterogeneous group of neoplasms of the bile ducts and represents the second most common hepatic cancer after hepatocellular carcinoma; it is sub-classified as intrahepatic cholangiocarcinoma (iCCA) and extrahepatic cholangiocarcinoma (eCCA), the latter comprising both perihilar cholangiocarcinoma (pCCA or Klatskin tumor), and distal cholangiocarcinoma (dCCA).The global incidence of CCA has increased worldwide in recent decades. Chronic inflammation of biliary epithelium and bile stasis represent the main risk factors shared by all CCA sub-types.When feasible, liver resection is the treatment of choice for CCA, followed by systemic chemotherapy with capecitabine. Liver transplants represent a treatment option in patients with very early iCCA, in referral centers only. CCA diagnosis is often performed at an advanced stage when CCA is unresectable. In this setting, systemic chemotherapy with gemcitabine and cisplatin represents the first treatment option, but the prognosis remains poor.In order to ameliorate patients’ survival, new drugs have been studied in the last few years. Target therapies are directed against different molecules, which are altered in CCA cells. These therapies have been studied as second-line therapy, alone or in combination with chemotherapy. In the same setting, the immune checkpoints inhibitors targeting programmed death 1 (PD-1), programmed death-ligand 1 (PD-L1), cytotoxic T-lymphocyte antigen-4 (CTLA-4), have been proposed, as well as cancer vaccines and adoptive cell therapy (ACT). These experimental treatments showed promising results and have been proposed as second- or third-line treatment, alone or in combination with chemotherapy or target therapies. |
| first_indexed | 2024-04-11T14:13:09Z |
| format | Article |
| id | doaj.art-14163535876c4e698c8829aa675af86e |
| institution | Directory Open Access Journal |
| issn | 1665-2681 |
| language | English |
| last_indexed | 2024-04-11T14:13:09Z |
| publishDate | 2022-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Annals of Hepatology |
| spelling | doaj.art-14163535876c4e698c8829aa675af86e2022-12-22T04:19:37ZengElsevierAnnals of Hepatology1665-26812022-09-01275100737Clinical treatment of cholangiocarcinoma: an updated comprehensive reviewAlessandra Elvevi0Alice Laffusa1Miki Scaravaglio2Roberta Elisa Rossi3Raffaella Longarini4Anna Maria Stagno5Laura Cristoferi6Antonio Ciaccio7Diego Luigi Cortinovis8Pietro Invernizzi9Sara Massironi10Division of Gastroenterology and Center for Autoimmune Liver Diseases, San Gerardo Hospital and Department of Medicine and Surgery, University of Milano-Bicocca, Monza, ItalyDivision of Gastroenterology and Center for Autoimmune Liver Diseases, San Gerardo Hospital and Department of Medicine and Surgery, University of Milano-Bicocca, Monza, ItalyDivision of Gastroenterology and Center for Autoimmune Liver Diseases, San Gerardo Hospital and Department of Medicine and Surgery, University of Milano-Bicocca, Monza, ItalyGastroenterology and Endoscopy Unit, Humanitas Clinical and Research Center, IRCCS, Rozzano, Milan, ItalyDivision of Oncology, San Gerardo Hospital and Department of Medicine and Surgery, University of Milano-Bicocca, Monza, ItalyDivision of Oncology, San Gerardo Hospital and Department of Medicine and Surgery, University of Milano-Bicocca, Monza, ItalyDivision of Gastroenterology and Center for Autoimmune Liver Diseases, San Gerardo Hospital and Department of Medicine and Surgery, University of Milano-Bicocca, Monza, ItalyDivision of Gastroenterology and Center for Autoimmune Liver Diseases, San Gerardo Hospital and Department of Medicine and Surgery, University of Milano-Bicocca, Monza, ItalyDivision of Oncology, San Gerardo Hospital and Department of Medicine and Surgery, University of Milano-Bicocca, Monza, ItalyDivision of Gastroenterology and Center for Autoimmune Liver Diseases, San Gerardo Hospital and Department of Medicine and Surgery, University of Milano-Bicocca, Monza, ItalyDivision of Gastroenterology and Center for Autoimmune Liver Diseases, San Gerardo Hospital and Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy; Corresponding author.Cholangiocarcinoma (CCA) is a heterogeneous group of neoplasms of the bile ducts and represents the second most common hepatic cancer after hepatocellular carcinoma; it is sub-classified as intrahepatic cholangiocarcinoma (iCCA) and extrahepatic cholangiocarcinoma (eCCA), the latter comprising both perihilar cholangiocarcinoma (pCCA or Klatskin tumor), and distal cholangiocarcinoma (dCCA).The global incidence of CCA has increased worldwide in recent decades. Chronic inflammation of biliary epithelium and bile stasis represent the main risk factors shared by all CCA sub-types.When feasible, liver resection is the treatment of choice for CCA, followed by systemic chemotherapy with capecitabine. Liver transplants represent a treatment option in patients with very early iCCA, in referral centers only. CCA diagnosis is often performed at an advanced stage when CCA is unresectable. In this setting, systemic chemotherapy with gemcitabine and cisplatin represents the first treatment option, but the prognosis remains poor.In order to ameliorate patients’ survival, new drugs have been studied in the last few years. Target therapies are directed against different molecules, which are altered in CCA cells. These therapies have been studied as second-line therapy, alone or in combination with chemotherapy. In the same setting, the immune checkpoints inhibitors targeting programmed death 1 (PD-1), programmed death-ligand 1 (PD-L1), cytotoxic T-lymphocyte antigen-4 (CTLA-4), have been proposed, as well as cancer vaccines and adoptive cell therapy (ACT). These experimental treatments showed promising results and have been proposed as second- or third-line treatment, alone or in combination with chemotherapy or target therapies.http://www.sciencedirect.com/science/article/pii/S1665268122000795primary liver cancerscholangiocarcinomabiliary tract neoplasmtherapiestreatment |
| spellingShingle | Alessandra Elvevi Alice Laffusa Miki Scaravaglio Roberta Elisa Rossi Raffaella Longarini Anna Maria Stagno Laura Cristoferi Antonio Ciaccio Diego Luigi Cortinovis Pietro Invernizzi Sara Massironi Clinical treatment of cholangiocarcinoma: an updated comprehensive review Annals of Hepatology primary liver cancers cholangiocarcinoma biliary tract neoplasm therapies treatment |
| title | Clinical treatment of cholangiocarcinoma: an updated comprehensive review |
| title_full | Clinical treatment of cholangiocarcinoma: an updated comprehensive review |
| title_fullStr | Clinical treatment of cholangiocarcinoma: an updated comprehensive review |
| title_full_unstemmed | Clinical treatment of cholangiocarcinoma: an updated comprehensive review |
| title_short | Clinical treatment of cholangiocarcinoma: an updated comprehensive review |
| title_sort | clinical treatment of cholangiocarcinoma an updated comprehensive review |
| topic | primary liver cancers cholangiocarcinoma biliary tract neoplasm therapies treatment |
| url | http://www.sciencedirect.com/science/article/pii/S1665268122000795 |
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