New systemic treatment paradigms in advanced biliary tract cancer and variations in patient access across Europe
The Lancet Regional Health - Europe,
Год журнала:
2025,
Номер
50, С. 101170 - 101170
Опубликована: Фев. 19, 2025
In
recent
years,
treatment
options
for
patients
with
advanced
biliary
tract
cancer
(BTC)
have
increased
significantly
due
to
the
positive
results
from
phase
2/3
clinical
trials
of
immune
checkpoint
inhibitors,
combined
chemotherapy,
and
molecularly
targeted
agents.
These
advances
led
need
molecular
testing
identify
actionable
alterations
amenable
therapies.
However,
these
improvements
brought
them
many
questions
challenges,
including
identification
resistance
mechanisms
therapeutic
sequences.
this
Series
paper
we
aim
provide
an
overview
current
systemic
BTC,
highlighting
disparities
in
access
innovative
treatments
across
European
countries,
which
lead
inequalities
possibilities
treating
BTC.
We
also
discuss
how
ongoing
collaborative
projects,
such
as
COST
Action
Precision-BTC-Network
CA22125,
supported
by
(European
Cooperation
Science
Technology),
linked
Network
Study
Cholangiocarcinoma
(ENSCCA),
can
help
overcome
improve
scenario.
Язык: Английский
Claudin 18.2: a promising actionable target in biliary tract cancers
ESMO Open,
Год журнала:
2025,
Номер
10(5), С. 105049 - 105049
Опубликована: Апрель 10, 2025
Язык: Английский
Morpho-molecular approach (NGS plus digital PCR) in diagnosis of malignant biliary strictures
Pathologica,
Год журнала:
2025,
Номер
117(1), С. 10 - 17
Опубликована: Апрель 1, 2025
To
analyze
the
diagnostic
accuracy
and
feasibility
of
digital-PCR
(dPCR)
combined
with
next-generation
sequencing
(NGS)
in
ERCP-guided
histological
diagnosis
biliary
strictures
to
overcome
issue
represented
by
scarcity
sampled
material.
Twenty-two
prospective
patients
were
included,
submitted
ERPC-guided
biopsy
or
resection.
By
histopathological
analysis
plus
fluorescence
situ
hybridization
(FISH)
for
chromosomes
3,
7,
17
aneuploidies,
8
cases
(36.4%)
malignant,
14
(63.6%)
negative.
NGS
was
performed
on
paraffin-embedded
tissue
a
laboratory-developed
panel
allowing
hot-spot
regions
28
genes.
Digital
PCR
QuantStudio™
AbsoluteQ™
solid
dPCR
copy-number
variation
(CNV)
analysed.
At
dPCR,
1
case
showed
aneuploidy
chromosome
2
both
3
7.
These
all
belonged
positive
group
(p
=
0.014).
NGS,
6
at
least
one
mutated
gene,
<
0.001).
The
showing
also
mutations
NGS.
Basing
these
observations,
we
can
propose
algorithm:
be
applied
first,
malignancy
working
day
if
aneuploidies
are
observed.
In
negative
"second-line"
is
same
extracted
implementation
allowed
identification
nearly
40%
just
day.
procedure
start
nucleic
acid
used
requiring
more
time,
but
reaching
75%
sensitivity.
More
studies
required
identify
other
sensitive
specific
targets,
even
our
algorithm
does
not
increase
accuracy,
possibility
avoiding
FISH
time-
money-saving
fashion
might
an
important
step.
Язык: Английский
Precision oncology in biliary tract cancer: the emerging role of liquid biopsy
ESMO Open,
Год журнала:
2025,
Номер
10(5), С. 105079 - 105079
Опубликована: Май 1, 2025
Liquid
biopsy
has
already
proven
effective
in
aiding
diagnosis,
risk
stratification
and
treatment
personalization
several
malignancies,
it
could
represent
a
practice-changing
tool
also
biliary
tract
cancer,
even
though
clinical
applications
are
currently
still
limited.
It
is
promising
for
early
especially
high-risk
populations,
studies
on
circulating
free
DNA
(cfDNA),
tumour
cells
differential
microRNA
(miRNA)
profiles
this
setting
ongoing.
Circulating
(ctDNA)
appears
as
feasible
noninvasive
biomarker
the
curative
setting,
detecting
minimal
residual
disease
after
resection
monitoring
recurrence.
As
of
today,
can
be
particularly
valuable
cancer
genomic
profiling,
with
good
concordance
tissue
samples
most
molecular
alterations.
CtDNA
analysis
may
considered
practice
when
not
sufficient
next-generation
sequencing,
or
urgent
therapeutic
decisions
needed.
Moreover,
offers
possibility
providing
real-time
picture
to
monitor
response
dynamically
identify
resistance
mutations,
potentially
representing
way
optimize
strategies.
Язык: Английский
Recommendations on maximising the clinical value of tissue in the management of patients with intrahepatic cholangiocarcinoma
JHEP Reports,
Год журнала:
2024,
Номер
6(6), С. 101067 - 101067
Опубликована: Март 12, 2024
Background
&
AimsPatients
with
intrahepatic
cholangiocarcinoma
can
now
be
managed
targeted
therapies
directed
against
specific
molecular
alterations.
Consequently,
tissue
submitted
to
a
pathology
department
must
yield
information
in
addition
diagnosis
or,
resection
specimens,
staging
information.
The
pathologist's
role
reporting
these
specimens
has
therefore
changed
accommodate
such
personalised
approaches.
Methods:
We
have
developed
recommendations
and
guidance
for
pathologists
by
undertaking
systematic
review
of
existing
generate
candidate
statements
followed
an
international
Delphi
process.
59
from
28
countries
6
continents
rated
mapped
all
elements
the
specimen
pathway
receipt
authorisation
final
written
report.
A
separate
survey
'end-users'
report
including
surgeons,
oncologists,
gastroenterologists
was
undertaken
evaluate
what
should
included
enable
appropriate
patient
management.
Results:
48
reached
consensus
inclusion
10
about
content
that
also
'end-user'
participants.
proforma
allow
easy
recommended
data
points
is
provided.
Conclusions:
These
guiding
principles
provide
framework
maximise
informational
required
management.Impact
implicationsBiopsy
or
lesional
abnormalities
within
tumour
define
suitability
Here,
we
cases
using
process
sought
views
both
reports.
highlights
need
way
preserves
testing
emphasises
requires
interpretation
histological
features
broader
clinical
radiological
context.
will
uniform
manner
maximises
value
received
facilitate
optimal
multidisciplinary
Язык: Английский
Emerging Targeted Therapies and Strategies to Overcome Resistance in Biliary Tract Cancers
Critical Reviews in Oncology/Hematology,
Год журнала:
2024,
Номер
199, С. 104388 - 104388
Опубликована: Май 15, 2024
Язык: Английский
Emerging biomarkers for immunotherapy response in biliary tract cancers: a comprehensive review of immune checkpoint inhibitor strategies
Biomarkers in Medicine,
Год журнала:
2024,
Номер
18(15-16), С. 703 - 715
Опубликована: Авг. 15, 2024
Biliary
tract
cancers
(BTCs)
have
rising
incidence
and
mortality
rates.
Chemotherapy's
limited
efficacy
has
led
to
exploring
new
treatments
like
immunotherapy.
which
offers
modest
benefits.
Moreover,
the
identification
of
reliable
predictive
biomarkers
for
immune
checkpoint
therapy
in
BTCs
remains
elusive,
hindering
personalized
treatment
strategies.
This
review
provides
an
overview
current
landscape
emerging
immunotherapy
response
BTCs.
We
discuss
incremental
benefits
combination
evolving
role
managing
advanced
BTC.
Additionally,
we
highlight
need
robust
optimize
outcomes
foster
a
more
individualized
approach
patient
care.
aim
identify
promising
research
avenues
strategies
enhance
therapeutic
survival
Язык: Английский
Which therapy in biliary tract cancer? Review of main concerns in diagnosis and choice of therapy in advanced setting, current standard, and new options
Expert Opinion on Pharmacotherapy,
Год журнала:
2024,
Номер
unknown
Опубликована: Сен. 19, 2024
The
incidence
of
biliary
tract
cancer
is
increasing
in
developed
countries
and
generating
renewed
interest
the
scientific
community
due
to
evidence
a
high
percentage
(approximately
40%)
potentially
targetable
molecular
alterations.
However,
date,
patient
selection
development
therapeutic
approaches
remain
challenging
need
for
accurate
diagnosis,
adequate
sampling,
specialized
team
analysis,
centralization
patients
high-volume
centers
capable
supporting
cost
these
methods,
feasibility
clinical
studies
on
diseases
with
aggressive
onset
poor
prognosis.
In
this
article,
we
would
like
provide
detailed
overview
necessary
tools
diagnostic
framing
various
scenarios
being
investigated
concerning
most
frequently
detected
Язык: Английский