Personalized Medicine in Advanced Cholangiocarcinoma

IF 0.7 1区历史学 Q1 HISTORY

Oral History Review Pub Date : 2020-01-01 DOI:10.17925/ohr.2020.16.1.52

Anuhya Kommalapati, James Yu, R. Kim

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引用次数: 1

Abstract

Journal Publication Date: August 6, 2020 Personalized medicine is the new-generation concept of managing cancer, which primarily focuses on the development of targeted therapies blocking specific cellular pathways that potentiate the tumorigenesis and identify people that respond best. The combination of gemcitabine and a platinum agent, remains the first-line therapy in advanced cholangiocarcinoma. Thus far, there are no specific guidelines on the next step in the care of patients who progressed on, or could not tolerate, the first-line therapy. However, a better knowledge of molecular pathogenesis and advancements in the development of targeted therapy offers hope that we may improve outcomes in advanced cholangiocarcinoma. Among the newly discovered molecular alterations, targeting isocitrate dehydrogenase (IDH1/2) mutations, fibroblast growth factor receptor 2 (FGFR2) fusions, RAS-MAPK pathway activation, BRCA1/2 mutations, NTRK fusions, and human epidermal growth factor receptor 2 (HER2), hold great promise for improving the future management of cholangiocarcinoma. In tumors with high microsatellite instabilities or mismatch repair deficiencies irrespective of programmed death ligand (PD-L) 1 expression, immunotherapy, alone or in combination with targeted agents and chemotherapy, are currently being evaluated. This review article details the potential targetable molecular pathways and future directions in implementing personalized medicine in this dismal cancer.

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晚期胆管癌个体化治疗

个性化医疗是管理癌症的新一代概念，主要侧重于开发靶向疗法，阻断特定的细胞通路，从而增强肿瘤的发生，并确定反应最好的人。吉西他滨联合铂类药物仍然是晚期胆管癌的一线治疗方案。到目前为止，对于在一线治疗中取得进展或不能耐受的患者的下一步护理，还没有具体的指导方针。然而，对分子发病机制的更好了解和靶向治疗的进展为我们改善晚期胆管癌的预后提供了希望。在新发现的分子改变中，针对异柠檬酸脱氢酶(IDH1/2)突变、成纤维细胞生长因子受体2 (FGFR2)融合、RAS-MAPK通路激活、BRCA1/2突变、NTRK融合和人表皮生长因子受体2 (HER2)，对改善胆管癌的未来管理具有很大的希望。在微卫星不稳定性高或错配修复缺陷的肿瘤中，与程序性死亡配体(PD-L) 1表达无关，目前正在评估单独或联合靶向药物和化疗的免疫治疗。这篇综述文章详细介绍了潜在的靶向分子途径和在这种令人沮丧的癌症中实施个性化医疗的未来方向。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Oral History Review Multiple-

CiteScore

1.20

自引率

27.30%

发文量

期刊介绍： The Oral History Review, published by the Oral History Association, is the U.S. journal of record for the theory and practice of oral history and related fields. The journal’s primary mission is to explore the nature and significance of oral history and advance understanding of the field among scholars, educators, practitioners, and the general public. The Review publishes narrative and analytical articles and reviews, in print and multimedia formats, that present and use oral history in unique and significant ways and that contribute to the understanding of the nature of oral history and memory. It seeks previously unpublished works that demonstrate high-quality research and that offer new insight into oral history practice, methodology, theory, and pedagogy. Work published in the journal arises from many fields and disciplines, reflecting the interdisciplinary nature of oral history. While based in the U.S., the Review reflects the international scope of the field and encourages work from international authors and about international topics.