Systemic treatment of patients with locally advanced or metastatic cholangiocarcinoma – an Austrian expert consensus statement

Frontiers in Oncology

Oncology

Angela Djanani¹  Hossein Taghizadeh²  Thomas Winder³  Lukas Weiss⁴  Birgit Gruenberger⁵  Armin Gerger⁶  Wolfgang Eisterer⁷  Ewald Wöll⁸  Gerald W. Prager⁹  Thomas Gruenberger^1,10  Holger Rumpold^1,11 

[1] Clinical Division of Gastroenterology, Hepatology and Metabolism, Department of Internal Medicine, Medical University of Innsbruck, Innsbruck, Austria;Department of Internal Medicine I, University Hospital St. Pölten, St. Pölten, Austria;Karl Landsteiner University of Health Sciences, Krems, Austria;Department of Internal Medicine II, Hospital Feldkirch, Feldkirch, Austria;Department of Internal Medicine III, Paracelsus Medical University, Salzburg, Austria;Department of Internal Medicine and Hematology and Internal Oncology, Landesklinikum Wiener Neustadt, Wiener Neustadt, Austria;Department of Internal Medicine, Clinical Division of Oncology, Medical University of Graz, Graz, Austria;Department of Internal Medicine, Klagenfurt Hospital, Klagenfurt am Wörthersee, Austria;Department of Internal Medicine, Saint Vincent Hospital Zams, Zams, Austria;Department of Medicine I, Clinical Division of Oncology, Medical University of Vienna, Vienna, Austria;Department of Surgery, Clinic Favoriten, Hepatopancreatobiliary Center (HPB) Center, Health Network Vienna, and Sigmund Freud Private University, Vienna, Austria;Visceral Oncology Center, Ordensklinikum Linz, Linz, Austria;

关键词: biliary tract cancer (BTC);    cholangiocarcinoma;    molecular profiling;    targeted therapy;    chemotherapy;   

DOI  :  10.3389/fonc.2023.1225154

 received in 2023-05-18, accepted in 2023-08-11,  发布年份 2023

来源: Frontiers

【 摘 要 】

Locally advanced or metastatic cholangiocarcinoma is an aggressive carcinoma with a dismal prognosis. For the first-line treatment of locally advanced or metastatic cholangiocarcinoma, cisplatin/gemcitabine has been the standard of care for more than 10 years. Its combination with the immune checkpoint inhibitor durvalumab resulted in an efficiency improvement in the phase III setting. Regarding the use of chemotherapy in the second line, positive phase III data could only be generated for FOLFOX. The evidence base for nanoliposomal irinotecan (Nal-IRI) plus 5-fluorouracil (5-FU) and leucovorin (LV) is contradictory. After the failure of first-line treatment, targeted therapies can be offered if the molecular targets microsatellite instability-high (MSI-H), IDH1, FGFR2, BRAF V600E, and NTRK are detected. These targeted agents are generally preferable to second-line chemotherapy. Broad molecular testing should be performed, preferably from tumor tissue, at the initiation of first-line therapy to timely identify potential molecular targets.

【 授权许可】

Unknown   
Copyright © 2023 Taghizadeh, Djanani, Eisterer, Gerger, Gruenberger, Gruenberger, Rumpold, Weiss, Winder, Wöll and Prager