Paradigm shift of chemotherapy and systemic treatment for biliary tract cancer  

作　　者：Wattana Leowattana Tawithep Leowattana Pathomthep Leowattana 

机构地区：[1]Department of Clinical Tropical Medicine,Faculty of Tropical Medicine,Mahidol University,Rachatawee 10400,Bangkok,Thailand [2]Department of Medicine,Faculty of Medicine,Srinakharinwirot University,Wattana 10110,Bangkok,Thailand

出　　处：《World Journal of Gastrointestinal Oncology》2023年第6期959-972,共14页世界胃肠肿瘤学杂志（英文版）（电子版）

摘　　要：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.

关 键 词：Biliary tract cancers Gemcitabine and cisplatin combination Fibroblast growth factor receptor 2 inhibitors Isocitrate dehydrogenase 1 inhibitors Neurotrophic tyrosine receptor kinase gene fusion inhibitors Immune checkpoint inhibitors Microsatellite instability high Infrigatinib Pemigatinib 

分 类 号：R735.8[医药卫生—肿瘤]