First-line chemotherapy plus immunotherapy in biliary tract cancer

Biliary tract cancers have the second highest primary liver tumour incidence after hepatocellular carcinoma. 1 Valle JW Kelley RK Nervi B Oh DY Zhu AX Biliary tract cancer. Lancet. 2021; 397: 428-444 Summary Full Text Full Text PDF PubMed Scopus (139) Google Scholar They are classified into three subtypes (intrahepatic cholangiocarcinoma, extrahepatic cholangiocarcinoma, and gallbladder carcinoma) on the basis of anatomical location, with specific epidemiological, molecular, and therapeutic features. 1 Valle JW Kelley RK Nervi B Oh DY Zhu AX Biliary tract cancer. Lancet. 2021; 397: 428-444 Summary Full Text Full Text PDF PubMed Scopus (139) Google Scholar The incidence of intrahepatic cholangiocarcinoma is increasing, particularly in high-income countries, in relation to improvement in the differential diagnosis of hepatocellular carcinoma and liver metastases from other adenocarcinomas, and the rising rates of obesity, diabetes, and alcohol use. 1 Valle JW Kelley RK Nervi B Oh DY Zhu AX Biliary tract cancer. Lancet. 2021; 397: 428-444 Summary Full Text Full Text PDF PubMed Scopus (139) Google Scholar Endemic forms of cholangiocarcinoma associated with liver flukes have been seen in Asia. 1 Valle JW Kelley RK Nervi B Oh DY Zhu AX Biliary tract cancer. Lancet. 2021; 397: 428-444 Summary Full Text Full Text PDF PubMed Scopus (139) Google Scholar The prognosis for patients with biliary tract cancers is poor (5-year overall survival rate lower than 20%), mainly due to diagnosis at an advanced stage in most (60–70%) patients. 1 Valle JW Kelley RK Nervi B Oh DY Zhu AX Biliary tract cancer. Lancet. 2021; 397: 428-444 Summary Full Text Full Text PDF PubMed Scopus (139) Google Scholar Gemcitabine and cisplatin plus durvalumab with or without tremelimumab in chemotherapy-naive patients with advanced biliary tract cancer: an open-label, single-centre, phase 2 studyGemcitabine and cisplatin plus immunotherapy showed promising efficacy and acceptable safety in patients with biliary tract cancer. Gemcitabine and cisplatin plus durvalumab are being evaluated in the phase 3, TOPAZ-1 study ( NCT03875235 ) as first-line treatment in patients with advanced biliary tract cancer. Full-Text PDF