Onkológia 5/2022

Current treatment options for advanced cholangiocarcinoma

Cholangiocarcinoma is a malignant disease of biliary tract. Incidence is relatively low, but still increasing especially in some regions of Asia. Treatment of primary resectable cholangiocarcinoma is surgical intervention. In case of locally advanced inoperable, or disseminated disease is the treatment of choice systemic chemotherapy. Standard of I. line therapy is combination of gemcitabine and platinum derivate (cisplatin/oxalipatin). Treatment of choice in II. line is regime based on oxaliplatin, eventually irinotecan. Same as in other malignancies, also in cholangiocarcinoma personalized medicine is accented. Recently, there are many ongoing studies which evaluate benefit of targeted therapy and immunotherapy. Considering multiple studies, innovative drugs could be use in case of presence specific gene aberrations and/or specific biological properties of tumor. Actionable mutations seem to be FGFR, BRAF, HER2, IDH-1, PD-L1 positivity etc. Another studies, research and evaluation of modern molecules are needed for improvement and treatment strategies changes especially in metastatic and locally advanced inoperable cholangiocarcinoma.

Keywords: cholangiocarcinoma, targeted therapy, chemotherapy, immunotherapy, NGS