Publication: Paradigm shift of chemotherapy and systemic treatment for biliary tract cancer
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Issued Date
2023
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application/pdf
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มหาวิทยาลัยศรีนครินทรวิโรฒ
Bibliographic Citation
World Journal of Gastrointestinal Oncology. Vol 15, No.6 (2023), p.959-972
Suggested Citation
Leowattana W., Leowattana T., Leowattana P. Paradigm shift of chemotherapy and systemic treatment for biliary tract cancer. World Journal of Gastrointestinal Oncology. Vol 15, No.6 (2023), p.959-972. doi:10.4251/wjgo.v15.i6.959 Retrieved from: https://hdl.handle.net/20.500.14740/10552
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Abstract
Biliary tract cancers (BTC) are frequently identified at late stages and have a poor prognosis due to limited systemic treatment regimens. For more than a decade, the combination of gemcitabine and cis-platin has served as the first-line standard treatment. There are few choices for second-line chemo-therapy. Targeted treatment with fibroblast growth factor receptor 2 inhibitors, neurotrophic tyrosine receptor kinase inhibitors, and isocitrate dehydrogenase 1 inhibitors has had important results. Immune checkpoint inhibitors (ICI) such as pembrolizumab are only used in first-line treatment for microsatellite instability high patients. The TOPAZ-1 trial's outcome is encouraging, and there are several trials underway that might soon put targeted treatment and ICI combos into first-line options. Newer targets and agents for existing goals are being studied, which may represent a paradigm shift in BTC management. Due to a scarcity of targetable mutations and the higher toxicity profile of the current medications, the new category of drugs may occupy a significant role in BTC therapies. © The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.