Abstract
Simple SummaryPatients with advanced BTC have poor prognosis and frequently experience symptoms that adversely impact their quality of life. In this review, we explore the potential complications of advanced BTC and its treatments. We also review the possible strategies and interventions available to manage these adverse events.Biliary tract carcinomas (BTCs) account for less than 1% of all cancers but are increasing in incidence. Prognosis is poor for BTC patients, with 5-year survival rates of less than 10%. While chemotherapy has been the mainstay treatment for patients with advanced BTC, immunotherapy and targeted therapies are being evaluated in numerous clinical trials and rapidly incorporated into clinical practice. As patients with BTC have reduced health-related quality of life (HRQoL) due to both tumor- and treatment-related symptoms, it is important for clinicians to recognize and manage these symptoms early. This review will highlight the anticipated complications from BTC and its systemic treatment, as well as their effects on HRQoL.
Highlights
Biliary tract carcinomas (BTCs) are a heterogeneous group of malignancies arising from the epithelial lining of the bile ducts or gallbladder [1,2]
When diagnosing BTC, it is important to distinguish between intrahepatic cholangiocarcinoma, extrahepatic cholangiocarcnoma, gallbladder cancer (GBC), and ampulla of Vater carcinoma (AVC) as each sub-type has its own specific characteristics and variations in tumor biology [2]
The phase III ABC-06 trial determined the addition of FOLFOX to active symptom control (ACS) improved median overall survival (OS) in patients with advanced BTC after progression on gemcitabine and cisplatin compared to ASC alone (6.2 months versus 5.3 months) [37]
Summary
Biliary tract carcinomas (BTCs) are a heterogeneous group of malignancies arising from the epithelial lining of the bile ducts or gallbladder [1,2]. When diagnosing BTC, it is important to distinguish between intrahepatic cholangiocarcinoma (iCCA), extrahepatic cholangiocarcnoma (eCCA), gallbladder cancer (GBC), and ampulla of Vater carcinoma (AVC) as each sub-type has its own specific characteristics and variations in tumor biology [2]. 5-year overall survival (OS) following curative surgical resection differs based on anatomic site, for patients with cholangiocarcinoma (CCA), it is estimated. Systemic chemotherapy is the standard treatment for advanced BTC and can currently lead to a median OS of approximately 12 months [6]. While some physical symptoms are common to patients with advanced cancer, many are unique to BTC and its treatment.
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