Immunotherapy for the treatment of biliary tract cancer: an evolving landscape
Biliary tract cancers (BTCs), consisting of intrahepatic and extrahepatic cholangiocarcinoma and gallbladder cancer, are an aggressive, heterogeneous malignancy. They are most often diagnosed in the locally advanced or metastatic setting, at which point treatment consists of systemic therapy or best...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
SAGE Publishing
2024-03-01
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| Series: | Therapeutic Advances in Medical Oncology |
| Online Access: | https://doi.org/10.1177/17588359241235799 |
| _version_ | 1797271948587171840 |
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| author | Helen Catherine Wilbur Nilofer S. Azad |
| author_facet | Helen Catherine Wilbur Nilofer S. Azad |
| author_sort | Helen Catherine Wilbur |
| collection | DOAJ |
| description | Biliary tract cancers (BTCs), consisting of intrahepatic and extrahepatic cholangiocarcinoma and gallbladder cancer, are an aggressive, heterogeneous malignancy. They are most often diagnosed in the locally advanced or metastatic setting, at which point treatment consists of systemic therapy or best supportive care. Our understanding of the tumor microenvironment and the molecular classification has led to the identification of targetable mutations, such as isocitrate dehydrogenase 1 and fibroblast growth factor receptor 2. Despite the identification of these genomic alterations, until recently, little advancement had been made in the first-line setting for advanced BTC. While immunotherapy (IO) has revolutionized the treatment of many malignancies, the use of IO in BTC had yielded limited results prior to TOPAZ-1. In this review, we discuss the systemic therapeutic advances for BTC over the past decade, the rationale for immunotherapy in BTC, prior trials utilizing IO in BTC, and current and emerging immune-based therapeutic options. We further analyze the culmination of these advances, which resulted in the approval of durvalumab with gemcitabine and cisplatin for the first-line treatment of BTC per TOPAZ-1. We also discuss the results of KEYNOTE-966, which similarly reported improved clinical outcomes with the use of pembrolizumab in combination with gemcitabine and cisplatin. |
| first_indexed | 2024-03-07T14:17:32Z |
| format | Article |
| id | doaj.art-7c625ab8bd2b4094843aa3c776fc2f95 |
| institution | Directory Open Access Journal |
| issn | 1758-8359 |
| language | English |
| last_indexed | 2024-03-07T14:17:32Z |
| publishDate | 2024-03-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Medical Oncology |
| spelling | doaj.art-7c625ab8bd2b4094843aa3c776fc2f952024-03-06T11:03:39ZengSAGE PublishingTherapeutic Advances in Medical Oncology1758-83592024-03-011610.1177/17588359241235799Immunotherapy for the treatment of biliary tract cancer: an evolving landscapeHelen Catherine WilburNilofer S. AzadBiliary tract cancers (BTCs), consisting of intrahepatic and extrahepatic cholangiocarcinoma and gallbladder cancer, are an aggressive, heterogeneous malignancy. They are most often diagnosed in the locally advanced or metastatic setting, at which point treatment consists of systemic therapy or best supportive care. Our understanding of the tumor microenvironment and the molecular classification has led to the identification of targetable mutations, such as isocitrate dehydrogenase 1 and fibroblast growth factor receptor 2. Despite the identification of these genomic alterations, until recently, little advancement had been made in the first-line setting for advanced BTC. While immunotherapy (IO) has revolutionized the treatment of many malignancies, the use of IO in BTC had yielded limited results prior to TOPAZ-1. In this review, we discuss the systemic therapeutic advances for BTC over the past decade, the rationale for immunotherapy in BTC, prior trials utilizing IO in BTC, and current and emerging immune-based therapeutic options. We further analyze the culmination of these advances, which resulted in the approval of durvalumab with gemcitabine and cisplatin for the first-line treatment of BTC per TOPAZ-1. We also discuss the results of KEYNOTE-966, which similarly reported improved clinical outcomes with the use of pembrolizumab in combination with gemcitabine and cisplatin.https://doi.org/10.1177/17588359241235799 |
| spellingShingle | Helen Catherine Wilbur Nilofer S. Azad Immunotherapy for the treatment of biliary tract cancer: an evolving landscape Therapeutic Advances in Medical Oncology |
| title | Immunotherapy for the treatment of biliary tract cancer: an evolving landscape |
| title_full | Immunotherapy for the treatment of biliary tract cancer: an evolving landscape |
| title_fullStr | Immunotherapy for the treatment of biliary tract cancer: an evolving landscape |
| title_full_unstemmed | Immunotherapy for the treatment of biliary tract cancer: an evolving landscape |
| title_short | Immunotherapy for the treatment of biliary tract cancer: an evolving landscape |
| title_sort | immunotherapy for the treatment of biliary tract cancer an evolving landscape |
| url | https://doi.org/10.1177/17588359241235799 |
| work_keys_str_mv | AT helencatherinewilbur immunotherapyforthetreatmentofbiliarytractcanceranevolvinglandscape AT nilofersazad immunotherapyforthetreatmentofbiliarytractcanceranevolvinglandscape |