Learn about the types of bile duct cancer, risk factors, clinical features, staging, and treatment for bile duct cancer in this expert-reviewed summary. A number of studies show the usefulness of radiation therapy for biliary tract cancer, but most of these studies are small prospective or retrospective studies, so studies that confer high-level evidence are limited. In the presence of metastasis to the liver, lung, peritoneum, or distant lymph nodes, curative resection is not suitable. Treatment protocols for biliary tract cancer are provided below, including surgery, adjuvant therapies, systemic therapies, and single-agent regimens. Abstract: Surgical resection remains the most important treatment for patients with biliary tract cancer (BTC), but despite radical surgical techniques many patients ultimately develop recurrent disease. Gallbladder cancer is the most common cancer of the biliary tract and the third most common cancer of the gastrointestinal tract. Expert Opinion on Emerging Drugs. Gallbladder cancer and cholangiocarcinoma are collectively known as biliary tract cancers (BTC). Pancreatic and biliary tract cancer guidelines have been updated together including the recommendation of adjuvant treatment in pancreatic and biliary tract cancer. Biliary tract cancers usually present at an advanced stage, and only approximately 20% of tumors are considered resectable. Thus, chemotherapy for patients with biliary tract cancer seems to be a significant treatment of choice. On January 18, 2020, KN035 was granted FDA Orphan Drug Designation (ODD) for the treatment of advanced biliary tract cancer (BTC). Background: The Japanese Society of Hepato-Biliary-Pancreatic Surgery launched the clinical practice guidelines for the management of biliary tract cancers (cholangiocarcinoma, gallbladder cancer, and ampullary cancer) in 2007, then published the 2nd version in 2014. Thus, radiation therapy is not a standard treatment in biliary tract cancer. 2018;23(1):63-75. An estimated 42,030 new cases of liver cancer (including intrahepatic bile duct cancers) and 12,360 new cases of gallbladder or other biliary cancers were diagnosed in the United States in 2019. Most bile duct cancers cannot be completely removed by surgery. Therefore, the suitability of curative resection should be investigated in the first place. No definite consensus has been reached on local extension factors and curability. Treatment of bile duct cancer depends on where the cancer has formed and if it can be removed by surgery (resectable) or not (unresectable). Lombardi P, Marino D, Fenocchio E, et al. BTC encompasses several distinct disease entities—intrahepatic, perihilar and distal bile duct cholangiocarcinoma as well as gallbladder cancer. National Comprehensive Cancer Network, Clinical Practice Guidelines in Oncology (NCCN Guidelines®), Hepatobiliary Cancers, Version 2.2018 -- June 7, 2018. Biliary tract cancer consists of tumors that arise from epithelial cells lining the biliary tract, which consists of the intrahepatic bile duct, extrahepatic bile duct, gall bladder, and ampulla of Vater. However, chemotherapy for patients with biliary tract cancer should be indicated for those with unresectable, locally advanced disease or distant metastasis, or … Bile duct cancer (also called cholangiocarcinoma) can occur in the bile ducts in the liver (intrahepatic) or outside the liver (perihilar or distal ). The only curative treatment in biliary tract cancer is surgical treatment. Other treatments include radiation, chemotherapy, and palliative therapies like stent placement and biliary bypass. In patients with biliary tract cancer (BTC), surgery followed by adjuvant capecitabine (BILCAP phase 3 trial) is the only potentially curative option, but patients often present with advanced disease, and palliative systemic treatment is given. Emerging molecular target antagonists for the treatment of biliary tract cancer. Methods: In this 3rd version, clinical questions (CQs) were proposed in six topics.
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