Adjuvant therapies for biliary tract cancers

[摘要] Biliary tract cancers (BTC) represent a heterogenous group, including gallbladder cancer, intrahepatic, perihilar, and distal cholangiocarcinoma (see Figure 1). Although these tumors all represent malignant transformation of epithelium with biliary differentiation, they have proven to be incredibly diverse from a genetic standpoint. Improved selection, operative techniques, and perioperative care have benefitted patients with these tumors; however, recurrence rates remain high and survival poor.1 Chemotherapeutic options for these patients have been limited and reserved most often for metastatic or recurrent disease. The Advanced Biliary Cancer [also known as the ABC]-02 trial compared gemcitabine to the combination of gemcitabine and cisplatin in patients with recurrent or metastatic BTCs demonstrating an improved survival in the gemcitabine-cisplatin group (11.7 months versus 8.1 months, p<0.001).2 The relative rarity of these diseases, extensive resections, as well as the heterogenous nature of BTCs remain hurdles to optimal therapy in the adjuvant setting; however, three important trials were recently completed and reported: SWOG (also known as the Southwest Oncology Group) S0809,3 PRODIGE 12–ACCORD 18 trial (Gemcitabine Hydrochloride and Oxaliplatin or Observation in Treating Patients with Biliary Tract Cancer that Has Been Removed by Surgery),4 and BILCAP (also known as Capecitabine or Observation after Surgery in Treating Patients with Biliary Tract Cancer)5 (see Table 1).

[学科分类] 外科医学