Biliary tract cancers (BTCs) are a heterogeneous group of malignancies with a dismal prognosis. Despite radical surgery, the five-year overall survival (OS) does not exceed 40% in the best series. Adjuvant treatments are widely used even though they have mainly been investigated in small retrospective series until recently. Available data suggest that chemotherapy with 5-fluorouracil (and relative prodrugs) or gemcitabine can reduce the risk of relapse and potentially improve patients' long-term outcome. The role of adjuvant radiotherapy seems to be confined to patients with positive surgical margins. In addition, patients with high-risk factors for relapse (nodal involvement and non-radical resection) benefit most from chemotherapy. Recent results from large randomized trials have clarified the benefit of adjuvant treatments and probably defined a new standard of care.
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http://dx.doi.org/10.21037/tcr.2018.08.17 | DOI Listing |
Chem Biol Drug Des
January 2025
Department of Hepato-Biliary-Pancreatic Surgery, Shaoxing People's Hospital, Shaoxing, People's Republic of China.
Gallbladder cancer is the most prevalent malignancy of the biliary tract and has a dismal overall survival even in the present day. The development of new drugs holds promise for improving the prognosis of this lethal disease. The possible anti-neoplastic role of morusin was investigated both in vitro and in vivo.
View Article and Find Full Text PDFRofo
January 2025
Department of Diagnostic and Interventional Radiology, University Hospital Würzburg, Würzburg, Germany.
To evaluate the feasibility of liver tract embolization after transhepatic biliary drainage using a biodegradable polymer plug (IMPEDE-FX, Shape Memorial Medical, Santa Clara, CA, USA).In a retrospective observational study, 15 plug embolizations were performed in 13 patients at risk for tract-related adverse events (AEs). Risk factors included coagulopathy, cirrhosis, central bile duct puncture, previous drain-related bleeding, malignant obstruction, large tract diameter, or multilevel strictures.
View Article and Find Full Text PDFAm Fam Physician
January 2025
University of Florida College of Medicine, Gainesville.
Jaundice is an indication of hyperbilirubinemia and is caused by derangements in bilirubin metabolism. It is typically apparent when serum bilirubin levels exceed 3 mg/dL and can indicate serious underlying disease of the liver or biliary tract. A comprehensive medical history, review of systems, and physical examination are essential for differentiating potential causes such as alcoholic liver disease, biliary strictures, choledocholithiasis, drug-induced liver injury, hemolysis, or hepatitis.
View Article and Find Full Text PDFOncol Lett
March 2025
Program in Translational Medicine, Chakri Naruebodindra Medical Institute, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Samutprakarn 10540, Thailand.
Cholangiocarcinoma (CCA) is a biliary tract carcinoma that is challenging to treat due to its heterogeneity and limited treatment options. Genetic alterations in DNA damage response (DDR) pathways and homologous recombination (HR) defects are common in CCA. This has prompted interest in the use of ataxia telangiectasia and Rad3-related protein (ATR) and poly(ADP-ribose) polymerase (PARP) inhibitors to treat CCA.
View Article and Find Full Text PDFCancer Chemother Pharmacol
January 2025
Clinical Pharmacology & Quantitative Pharmacology, BioPharmaceuticals R&D, AstraZeneca, Waltham, MA, USA.
Purpose: Durvalumab in combination with gemcitabine/cisplatin has shown a favorable benefit-risk profile in the TOPAZ-1 study for advanced biliary tract cancers (BTC). This analysis evaluated the population pharmacokinetics (PopPK) of durvalumab, and exposure-response for efficacy and safety (ERES) of TOPAZ-1.
Methods: The PopPK model for durvalumab was updated using data from 5 previously analysed studies and TOPAZ-1.
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