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Paradigm shift of chemotherapy and systemic treatment for biliary tract cancer
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 chem...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Baishideng Publishing Group Inc
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10302992/ https://www.ncbi.nlm.nih.gov/pubmed/37389105 http://dx.doi.org/10.4251/wjgo.v15.i6.959 |
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author | Leowattana, Wattana Leowattana, Tawithep Leowattana, Pathomthep |
author_facet | Leowattana, Wattana Leowattana, Tawithep Leowattana, Pathomthep |
author_sort | Leowattana, Wattana |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-10302992 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Baishideng Publishing Group Inc |
record_format | MEDLINE/PubMed |
spelling | pubmed-103029922023-06-29 Paradigm shift of chemotherapy and systemic treatment for biliary tract cancer Leowattana, Wattana Leowattana, Tawithep Leowattana, Pathomthep World J Gastrointest Oncol Minireviews 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. Baishideng Publishing Group Inc 2023-06-15 2023-06-15 /pmc/articles/PMC10302992/ /pubmed/37389105 http://dx.doi.org/10.4251/wjgo.v15.i6.959 Text en ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. |
spellingShingle | Minireviews Leowattana, Wattana Leowattana, Tawithep Leowattana, Pathomthep Paradigm shift of chemotherapy and systemic treatment for biliary tract cancer |
title | Paradigm shift of chemotherapy and systemic treatment for biliary tract cancer |
title_full | Paradigm shift of chemotherapy and systemic treatment for biliary tract cancer |
title_fullStr | Paradigm shift of chemotherapy and systemic treatment for biliary tract cancer |
title_full_unstemmed | Paradigm shift of chemotherapy and systemic treatment for biliary tract cancer |
title_short | Paradigm shift of chemotherapy and systemic treatment for biliary tract cancer |
title_sort | paradigm shift of chemotherapy and systemic treatment for biliary tract cancer |
topic | Minireviews |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10302992/ https://www.ncbi.nlm.nih.gov/pubmed/37389105 http://dx.doi.org/10.4251/wjgo.v15.i6.959 |
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