Background: Despite an increasing incidence, biliary tumors are still considered a rare tumor entity. Due to an often long clinically inapparent course and a lack of early detection strategies, surgical resection is often not possible at the time of diagnosis. Since 2010, chemotherapy with gemcitabine and cisplatin is considered the standard of care in the palliative situation. Only recently, first studies have been published or initiated that expand the treatment options in the first line and, for the first time, also suggest valid systemic approaches in the second line. Summary: Molecularly targeted therapies in selected patient subgroups are rapidly changing the field. In addition to IDH1 mutations and FGFR2 fusions in patients with intrahepatic tumors, the therapeutic relevance of rare but targetable alterations such as HER2/neu amplification, NTRK fusions, or BRAF mutations should be considered in patients with biliary tract cancers. Key Message: The current study landscape clearly shows that precision medicine will play an important role in the therapy of biliary malignancies and underlines the importance of early tumor genetic diagnostics. In this article we provide an overview of systemic therapy concepts in the adjuvant and palliative setting.
Visc Med

中文翻译：

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胆道癌当前和未来的全身治疗

背景：尽管发病率不断增加，但胆道肿瘤仍被认为是一种罕见的肿瘤实体。由于临床上不明显的病程通常很长并且缺乏早期发现策略，因此在诊断时通常无法进行手术切除。自 2010 年以来，吉西他滨和顺铂化疗被认为是姑息治疗的标准治疗方法。直到最近，才发表或启动了第一批扩大一线治疗选择的研究，并且首次提出了有效的二线治疗方法。概括：在选定的患者亚组中进行分子靶向治疗正在迅速改变这一领域。除了肝内肿瘤患者的 IDH1 突变和 FGFR2 融合外，还应考虑胆道癌患者中罕见但可靶向的改变（如 HER2/neu 扩增、NTRK 融合或 BRAF 突变）的治疗相关性。关键信息：目前的研究前景清楚地表明，精准医学将在胆道恶性肿瘤的治疗中发挥重要作用，并强调早期肿瘤基因诊断的重要性。在本文中，我们概述了辅助和姑息治疗中的全身治疗概念。
粘性医学