Abstract
Simple SummaryFor decades, there has been no globally accepted neoadjuvant or adjuvant therapy in resectable biliary tract cancer. Based on the results of the BILCAP trial, adjuvant capecitabine has been widely regarded as standard adjuvant therapy. Focusing on the management of resectable biliary tract cancer, this article reviews each therapeutic strategy including surgery, chemotherapy and radiotherapy, and summarises published and ongoing clinical trials of neoadjuvant and adjuvant therapy.Biliary tract cancers (BTCs) are a group of aggressive malignancies that arise from the bile duct and gallbladder. BTCs include intrahepatic cholangiocarcinoma (IH-CCA), extrahepatic cholangiocarcinoma (EH-CCA), and gallbladder cancer (GBCA). BTCs are highly heterogeneous cancers in terms of anatomical, clinical, and pathological characteristics. Until recently, the treatment of resectable BTC, including surgery, adjuvant chemotherapy, and radiation therapy, has largely been based on institutional practice guidelines and evidence from small retrospective studies. Recently, several large randomized prospective trials have been published, and there are ongoing randomized trials for resectable BTC. In this article, we review prior and recently updated evidence regarding surgery, adjuvant and neoadjuvant chemotherapy, and adjuvant radiation therapy for patients with resectable BTC.
Highlights
Biliary tract cancers (BTCs) are a group of aggressive malignancies that arise from the bile duct and gallbladder
An improved recent understanding of genetic characteristics of BTC has increased the chances of incorporation of molecular targeted therapy in the management of unresectable or metastatic BTC such as fibroblast growth factor receptor (FGFR) inhibitors, isocitrate dehydrogenase (IDH)-1 inhibitor, and human epidermal growth factor receptor 2 (HER2) inhibitors [9,10,11,12]
It is interesting that gemcitabine plus oxaliplatin (GEMOX), which is likely to have comparable efficacy to gemcitabine plus cisplatin (GemCis), is the current standard therapy for locally advanced and metastatic BTC patients based on ABC-02 trial
Summary
Biliary tract cancers (BTCs) are a group of aggressive malignancies that arise from the bile duct and gallbladder. BTCs are well known to have a dismal prognosis, with estimated 5-year overall survival (OS) rates of 6–26% for localized disease and 1–2% for metastatic disease [2,3]. An improved recent understanding of genetic characteristics of BTC has increased the chances of incorporation of molecular targeted therapy in the management of unresectable or metastatic BTC such as fibroblast growth factor receptor (FGFR) inhibitors, isocitrate dehydrogenase (IDH)-1 inhibitor, and human epidermal growth factor receptor 2 (HER2) inhibitors [9,10,11,12]. The high recurrence rates and dismal prognosis of localized BTCs indicate the unmet need for effective adjuvant and neoadjuvant therapy. Cancers 2021, 13, 1647 garding surgery, adjuvant and neoadjuvant chemotherapy, and adjuvant radiation therapy for patients with resectable BTC
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
