Skip to main content
Top
Published in: Current Treatment Options in Oncology 10/2015

Open Access 01-10-2015 | Upper Gastrointestinal Cancers (L Rajdev, Section Editor)

Targeted Therapy in Biliary Tract Cancers

Authors: Amartej Merla, MD, Kenneth G. Liu, MD, Lakshmi Rajdev, MD

Published in: Current Treatment Options in Oncology | Issue 10/2015

Login to get access

Opinion statement

A paradigm shift towards molecular-based, personalized cancer therapeutics has occurred in recent years and a number of targeted drugs have emerged. Various targeted therapies like erlotinib, trastuzumab, and cetuximab have been approved in lung, breast, and colon cancers, respectively. Numerous clinical trials involving targeted drugs in biliary tract cancers are currently in progress, though none have been approved for this disease. Biliary tract cancers are divided into separate entities both anatomically and in terms of pathogenesis but are grouped together in most trials given their rarity. Combination chemotherapy involving cisplatin and gemcitabine is the current standard of care in the metastatic setting. In this review, we will discuss the various molecular pathways implicated in biliary tract cancers and potential therapeutic targets.
Literature
2.
go back to reference Klatskin G. Adenocarcinoma of the hepatic duct at its bifurcation within the porta hepatis. An unusual tumor with distinctive clinical and pathological features. Am J Med. 1965;38:241–56.CrossRefPubMed Klatskin G. Adenocarcinoma of the hepatic duct at its bifurcation within the porta hepatis. An unusual tumor with distinctive clinical and pathological features. Am J Med. 1965;38:241–56.CrossRefPubMed
3.
4.
go back to reference Lazcano-Ponce EC et al. Epidemiology and molecular pathology of gallbladder cancer. CA Cancer J Clin. 2001;51(6):349–64.CrossRefPubMed Lazcano-Ponce EC et al. Epidemiology and molecular pathology of gallbladder cancer. CA Cancer J Clin. 2001;51(6):349–64.CrossRefPubMed
5.
go back to reference Castro FA et al. Biliary tract cancer incidence in the United States—demographic and temporal variations by anatomic site. Int J Cancer. 2013;133(7):1664–71.PubMedCentralCrossRefPubMed Castro FA et al. Biliary tract cancer incidence in the United States—demographic and temporal variations by anatomic site. Int J Cancer. 2013;133(7):1664–71.PubMedCentralCrossRefPubMed
6.
7.
go back to reference Andia KM, Gederlini GA, Ferreccio RC. Gallbladder cancer: trend and risk distribution in Chile. Rev Med Chil. 2006;134(5):565–74.CrossRef Andia KM, Gederlini GA, Ferreccio RC. Gallbladder cancer: trend and risk distribution in Chile. Rev Med Chil. 2006;134(5):565–74.CrossRef
8.
go back to reference Altekruse SF et al. Geographic variation of intrahepatic cholangiocarcinoma, extrahepatic cholangiocarcinoma, and hepatocellular carcinoma in the United States. PLoS One. 2015;10(3), e0120574.PubMedCentralCrossRefPubMed Altekruse SF et al. Geographic variation of intrahepatic cholangiocarcinoma, extrahepatic cholangiocarcinoma, and hepatocellular carcinoma in the United States. PLoS One. 2015;10(3), e0120574.PubMedCentralCrossRefPubMed
9.
go back to reference Shaib YH et al. Rising incidence of intrahepatic cholangiocarcinoma in the United States: a true increase? J Hepatol. 2004;40(3):472–7.CrossRefPubMed Shaib YH et al. Rising incidence of intrahepatic cholangiocarcinoma in the United States: a true increase? J Hepatol. 2004;40(3):472–7.CrossRefPubMed
10.
go back to reference Shaib Y, El-Serag HB. The epidemiology of cholangiocarcinoma. Semin Liver Dis. 2004;24(2):115–25.CrossRefPubMed Shaib Y, El-Serag HB. The epidemiology of cholangiocarcinoma. Semin Liver Dis. 2004;24(2):115–25.CrossRefPubMed
11.
13.
14.
go back to reference Li M et al. Hepatitis B virus infection increases the risk of cholangiocarcinoma: a meta-analysis and systematic review. J Gastroenterol Hepatol. 2012;27(10):1561–8.CrossRefPubMed Li M et al. Hepatitis B virus infection increases the risk of cholangiocarcinoma: a meta-analysis and systematic review. J Gastroenterol Hepatol. 2012;27(10):1561–8.CrossRefPubMed
15.
go back to reference Welzel TM et al. Risk factors for intrahepatic and extrahepatic cholangiocarcinoma in the United States: a population-based case-control study. Clin Gastroenterol Hepatol. 2007;5(10):1221–8.PubMedCentralCrossRefPubMed Welzel TM et al. Risk factors for intrahepatic and extrahepatic cholangiocarcinoma in the United States: a population-based case-control study. Clin Gastroenterol Hepatol. 2007;5(10):1221–8.PubMedCentralCrossRefPubMed
16.
go back to reference Jain K et al. Sequential occurrence of preneoplastic lesions and accumulation of loss of heterozygosity in patients with gallbladder stones suggest causal association with gallbladder cancer. Ann Surg. 2014;260(6):1073–80.CrossRefPubMed Jain K et al. Sequential occurrence of preneoplastic lesions and accumulation of loss of heterozygosity in patients with gallbladder stones suggest causal association with gallbladder cancer. Ann Surg. 2014;260(6):1073–80.CrossRefPubMed
17.
18.
go back to reference Trivedi V et al. Gallbladder cancer: adenoma-carcinoma or dysplasia-carcinoma sequence? Gastroenterol Hepatol (N Y). 2008;4(10):735–7. Trivedi V et al. Gallbladder cancer: adenoma-carcinoma or dysplasia-carcinoma sequence? Gastroenterol Hepatol (N Y). 2008;4(10):735–7.
19.
go back to reference Mayo SC et al. National trends in the management and survival of surgically managed gallbladder adenocarcinoma over 15 years: a population-based analysis. J Gastrointest Surg. 2010;14(10):1578–91.CrossRefPubMed Mayo SC et al. National trends in the management and survival of surgically managed gallbladder adenocarcinoma over 15 years: a population-based analysis. J Gastrointest Surg. 2010;14(10):1578–91.CrossRefPubMed
20.
go back to reference Ribero D et al. Surgical approach for long-term survival of patients with intrahepatic cholangiocarcinoma: a multi-institutional analysis of 434 patients. Arch Surg. 2012;147(12):1107–13.CrossRefPubMed Ribero D et al. Surgical approach for long-term survival of patients with intrahepatic cholangiocarcinoma: a multi-institutional analysis of 434 patients. Arch Surg. 2012;147(12):1107–13.CrossRefPubMed
21.
go back to reference Farges O et al. Influence of surgical margins on outcome in patients with intrahepatic cholangiocarcinoma: a multicenter study by the AFC-IHCC-2009 study group. Ann Surg. 2011;254(5):824–29. discussion 830.CrossRefPubMed Farges O et al. Influence of surgical margins on outcome in patients with intrahepatic cholangiocarcinoma: a multicenter study by the AFC-IHCC-2009 study group. Ann Surg. 2011;254(5):824–29. discussion 830.CrossRefPubMed
22.
go back to reference Silva MA et al. Surgery for hilar cholangiocarcinoma; a 10 year experience of a tertiary referral centre in the UK. Eur J Surg Oncol. 2005;31(5):533–9.CrossRefPubMed Silva MA et al. Surgery for hilar cholangiocarcinoma; a 10 year experience of a tertiary referral centre in the UK. Eur J Surg Oncol. 2005;31(5):533–9.CrossRefPubMed
23.
go back to reference Valle J et al. Cisplatin plus gemcitabine versus gemcitabine for biliary tract cancer. N Engl J Med. 2010;362(14):1273–81.CrossRefPubMed Valle J et al. Cisplatin plus gemcitabine versus gemcitabine for biliary tract cancer. N Engl J Med. 2010;362(14):1273–81.CrossRefPubMed
24.
go back to reference Darwish Murad S et al. Efficacy of neoadjuvant chemoradiation, followed by liver transplantation, for perihilar cholangiocarcinoma at 12 US centers. Gastroenterology. 2012;143(1):88–98. e3; quiz e14.CrossRefPubMed Darwish Murad S et al. Efficacy of neoadjuvant chemoradiation, followed by liver transplantation, for perihilar cholangiocarcinoma at 12 US centers. Gastroenterology. 2012;143(1):88–98. e3; quiz e14.CrossRefPubMed
25.
go back to reference Agrawal S et al. Outcomes of adjuvant chemoradiation and predictors of survival after extended cholecystectomy in gall bladder carcinoma: a single institution experience from an endemic region. J Gastrointest Cancer. 2015;46(1):48–53.CrossRefPubMed Agrawal S et al. Outcomes of adjuvant chemoradiation and predictors of survival after extended cholecystectomy in gall bladder carcinoma: a single institution experience from an endemic region. J Gastrointest Cancer. 2015;46(1):48–53.CrossRefPubMed
26.
27.
go back to reference Glimelius B et al. Chemotherapy improves survival and quality of life in advanced pancreatic and biliary cancer. Ann Oncol. 1996;7(6):593–600.CrossRefPubMed Glimelius B et al. Chemotherapy improves survival and quality of life in advanced pancreatic and biliary cancer. Ann Oncol. 1996;7(6):593–600.CrossRefPubMed
28.
go back to reference Valle JW et al. Gemcitabine alone or in combination with cisplatin in patients with advanced or metastatic cholangiocarcinomas or other biliary tract tumours: a multicentre randomised phase II study—the UK ABC-01 Study. Br J Cancer. 2009;101(4):621–7.PubMedCentralCrossRefPubMed Valle JW et al. Gemcitabine alone or in combination with cisplatin in patients with advanced or metastatic cholangiocarcinomas or other biliary tract tumours: a multicentre randomised phase II study—the UK ABC-01 Study. Br J Cancer. 2009;101(4):621–7.PubMedCentralCrossRefPubMed
29.
go back to reference Furuse J, Okusaka T, Miyazaki M, et al., A randomized study of gemcitabine/cisplatin versus single-agent gemcitabine in patients with biliary cancer. J Clin Oncol, 2009. 27(15_suppl: abstr #4579). Furuse J, Okusaka T, Miyazaki M, et al., A randomized study of gemcitabine/cisplatin versus single-agent gemcitabine in patients with biliary cancer. J Clin Oncol, 2009. 27(15_suppl: abstr #4579).
30.
go back to reference Yang R et al. Efficacy of gemcitabine plus platinum agents for biliary tract cancers: a meta-analysis. Anti-Cancer Drugs. 2013;24(8):871–7.CrossRefPubMed Yang R et al. Efficacy of gemcitabine plus platinum agents for biliary tract cancers: a meta-analysis. Anti-Cancer Drugs. 2013;24(8):871–7.CrossRefPubMed
31.
go back to reference Pignochino Y et al. Targeting EGFR/HER2 pathways enhances the antiproliferative effect of gemcitabine in biliary tract and gallbladder carcinomas. BMC Cancer. 2010;10:631.PubMedCentralCrossRefPubMed Pignochino Y et al. Targeting EGFR/HER2 pathways enhances the antiproliferative effect of gemcitabine in biliary tract and gallbladder carcinomas. BMC Cancer. 2010;10:631.PubMedCentralCrossRefPubMed
32.
go back to reference Chang YT et al. Clinicopathological and prognostic significances of EGFR, KRAS and BRAF mutations in biliary tract carcinomas in Taiwan. J Gastroenterol Hepatol. 2014;29(5):1119–25.CrossRefPubMed Chang YT et al. Clinicopathological and prognostic significances of EGFR, KRAS and BRAF mutations in biliary tract carcinomas in Taiwan. J Gastroenterol Hepatol. 2014;29(5):1119–25.CrossRefPubMed
33.•
go back to reference Ross JS, et al. Comprehensive genomic profiling of biliary tract cancers to reveal tumor-specific differences and genomic alterations. J Clin Oncol, 2015. 33(3_suppl: abstr #231). This reference presented data on comprehensive genomic profiling in BTC, including the presence/absence of genetic mutations and their relative frequencies in the subtypes of BTC. Ross JS, et al. Comprehensive genomic profiling of biliary tract cancers to reveal tumor-specific differences and genomic alterations. J Clin Oncol, 2015. 33(3_suppl: abstr #231). This reference presented data on comprehensive genomic profiling in BTC, including the presence/absence of genetic mutations and their relative frequencies in the subtypes of BTC.
34.
go back to reference Li M et al. Whole-exome and targeted gene sequencing of gallbladder carcinoma identifies recurrent mutations in the ErbB pathway. Nat Genet. 2014;46(8):872–6.CrossRefPubMed Li M et al. Whole-exome and targeted gene sequencing of gallbladder carcinoma identifies recurrent mutations in the ErbB pathway. Nat Genet. 2014;46(8):872–6.CrossRefPubMed
36.
go back to reference Wang SN et al. Aberrant p53 expression and the development of gallbladder carcinoma and adenoma. Kaohsiung J Med Sci. 2006;22(2):53–9.CrossRefPubMed Wang SN et al. Aberrant p53 expression and the development of gallbladder carcinoma and adenoma. Kaohsiung J Med Sci. 2006;22(2):53–9.CrossRefPubMed
37.
go back to reference Saetta AA et al. High-level microsatellite instability is not involved in gallbladder carcinogenesis. Exp Mol Pathol. 2006;80(1):67–71.CrossRefPubMed Saetta AA et al. High-level microsatellite instability is not involved in gallbladder carcinogenesis. Exp Mol Pathol. 2006;80(1):67–71.CrossRefPubMed
38.
go back to reference Normanno N et al. Epidermal growth factor receptor (EGFR) signaling in cancer. Gene. 2006;366(1):2–16.CrossRefPubMed Normanno N et al. Epidermal growth factor receptor (EGFR) signaling in cancer. Gene. 2006;366(1):2–16.CrossRefPubMed
39.
go back to reference Yoshikawa D et al. Clinicopathological and prognostic significance of EGFR, VEGF, and HER2 expression in cholangiocarcinoma. Br J Cancer. 2008;98(2):418–25.PubMedCentralCrossRefPubMed Yoshikawa D et al. Clinicopathological and prognostic significance of EGFR, VEGF, and HER2 expression in cholangiocarcinoma. Br J Cancer. 2008;98(2):418–25.PubMedCentralCrossRefPubMed
41.
go back to reference Zhou YM et al. Significance of expression of epidermal growth factor (EGF) and its receptor (EGFR) in chronic cholecystitis and gallbladder carcinoma. Ai Zheng. 2003;22(3):262–5.PubMed Zhou YM et al. Significance of expression of epidermal growth factor (EGF) and its receptor (EGFR) in chronic cholecystitis and gallbladder carcinoma. Ai Zheng. 2003;22(3):262–5.PubMed
42.
go back to reference Philip PA et al. Phase II study of erlotinib in patients with advanced biliary cancer. J Clin Oncol. 2006;24(19):3069–74.CrossRefPubMed Philip PA et al. Phase II study of erlotinib in patients with advanced biliary cancer. J Clin Oncol. 2006;24(19):3069–74.CrossRefPubMed
43.
go back to reference Lubner SJ et al. Report of a multicenter phase II trial testing a combination of biweekly bevacizumab and daily erlotinib in patients with unresectable biliary cancer: a phase II consortium study. J Clin Oncol. 2010;28(21):3491–7.PubMedCentralCrossRefPubMed Lubner SJ et al. Report of a multicenter phase II trial testing a combination of biweekly bevacizumab and daily erlotinib in patients with unresectable biliary cancer: a phase II consortium study. J Clin Oncol. 2010;28(21):3491–7.PubMedCentralCrossRefPubMed
44.••
go back to reference Lee J et al. Gemcitabine and oxaliplatin with or without erlotinib in advanced biliary-tract cancer: a multicentre, open-label, randomised, phase 3 study. Lancet Oncol. 2012;13(2):181–8. This is the only published phase III trial investigating the use of a targeted agent (erlotinib) in BTC, looking at erlotinib in combination with gemcitabine and oxaliplatin.CrossRefPubMed Lee J et al. Gemcitabine and oxaliplatin with or without erlotinib in advanced biliary-tract cancer: a multicentre, open-label, randomised, phase 3 study. Lancet Oncol. 2012;13(2):181–8. This is the only published phase III trial investigating the use of a targeted agent (erlotinib) in BTC, looking at erlotinib in combination with gemcitabine and oxaliplatin.CrossRefPubMed
45.
go back to reference Gruenberger B et al. Cetuximab, gemcitabine, and oxaliplatin in patients with unresectable advanced or metastatic biliary tract cancer: a phase 2 study. Lancet Oncol. 2010;11(12):1142–8.CrossRefPubMed Gruenberger B et al. Cetuximab, gemcitabine, and oxaliplatin in patients with unresectable advanced or metastatic biliary tract cancer: a phase 2 study. Lancet Oncol. 2010;11(12):1142–8.CrossRefPubMed
46.•
go back to reference Malka D et al. Gemcitabine and oxaliplatin with or without cetuximab in advanced biliary-tract cancer (BINGO): a randomised, open-label, non-comparative phase 2 trial. Lancet Oncol. 2014;15(8):819–28. A randomized phase II trial evaluating the role of cetuximab in combination with gemcitabine/oxaliplatin in advanced BTC.CrossRefPubMed Malka D et al. Gemcitabine and oxaliplatin with or without cetuximab in advanced biliary-tract cancer (BINGO): a randomised, open-label, non-comparative phase 2 trial. Lancet Oncol. 2014;15(8):819–28. A randomized phase II trial evaluating the role of cetuximab in combination with gemcitabine/oxaliplatin in advanced BTC.CrossRefPubMed
47.•
go back to reference Chen JS et al. A KRAS mutation status-stratified randomized phase II trial of gemcitabine and oxaliplatin alone or in combination with cetuximab in advanced biliary tract cancer. Ann Oncol. 2015;26(5):943–9. A randomized phase II trial evaluating the role of cetuximab in combination with gemcitabine/oxaliplatin in advanced BTC.CrossRefPubMed Chen JS et al. A KRAS mutation status-stratified randomized phase II trial of gemcitabine and oxaliplatin alone or in combination with cetuximab in advanced biliary tract cancer. Ann Oncol. 2015;26(5):943–9. A randomized phase II trial evaluating the role of cetuximab in combination with gemcitabine/oxaliplatin in advanced BTC.CrossRefPubMed
48.
go back to reference Rubovszky G et al. Cetuximab, gemcitabine and capecitabine in patients with inoperable biliary tract cancer: a phase 2 study. Eur J Cancer. 2013;49(18):3806–12.CrossRefPubMed Rubovszky G et al. Cetuximab, gemcitabine and capecitabine in patients with inoperable biliary tract cancer: a phase 2 study. Eur J Cancer. 2013;49(18):3806–12.CrossRefPubMed
49.
go back to reference Hezel AF et al. Phase II study of gemcitabine, oxaliplatin in combination with panitumumab in KRAS wild-type unresectable or metastatic biliary tract and gallbladder cancer. Br J Cancer. 2014;111(3):430–6.PubMedCentralCrossRefPubMed Hezel AF et al. Phase II study of gemcitabine, oxaliplatin in combination with panitumumab in KRAS wild-type unresectable or metastatic biliary tract and gallbladder cancer. Br J Cancer. 2014;111(3):430–6.PubMedCentralCrossRefPubMed
50.
go back to reference Leone F, et al. A phase II, open-label, randomized clinical trial of panitumumab plus gemcitabine and oxaliplatin (GEMOX) versus GEMOX alone as first-line treatment in advanced biliary tract cancer: the Vecti-BIL study. J Clin Oncol, 2015. 33(3_suppl: abstr #281). Leone F, et al. A phase II, open-label, randomized clinical trial of panitumumab plus gemcitabine and oxaliplatin (GEMOX) versus GEMOX alone as first-line treatment in advanced biliary tract cancer: the Vecti-BIL study. J Clin Oncol, 2015. 33(3_suppl: abstr #281).
51.
go back to reference Jensen LH et al. Phase II marker-driven trial of panitumumab and chemotherapy in KRAS wild-type biliary tract cancer. Ann Oncol. 2012;23(9):2341–6.CrossRefPubMed Jensen LH et al. Phase II marker-driven trial of panitumumab and chemotherapy in KRAS wild-type biliary tract cancer. Ann Oncol. 2012;23(9):2341–6.CrossRefPubMed
52.
go back to reference Sohal DP et al. A phase II trial of gemcitabine, irinotecan and panitumumab in advanced cholangiocarcinoma. Ann Oncol. 2013;24(12):3061–5.CrossRefPubMed Sohal DP et al. A phase II trial of gemcitabine, irinotecan and panitumumab in advanced cholangiocarcinoma. Ann Oncol. 2013;24(12):3061–5.CrossRefPubMed
53.
go back to reference Menard S et al. Role of HER2/neu in tumor progression and therapy. Cell Mol Life Sci. 2004;61(23):2965–78.CrossRefPubMed Menard S et al. Role of HER2/neu in tumor progression and therapy. Cell Mol Life Sci. 2004;61(23):2965–78.CrossRefPubMed
54.
go back to reference Kiguchi K et al. Constitutive expression of ErbB-2 in gallbladder epithelium results in development of adenocarcinoma. Cancer Res. 2001;61(19):6971–6.PubMed Kiguchi K et al. Constitutive expression of ErbB-2 in gallbladder epithelium results in development of adenocarcinoma. Cancer Res. 2001;61(19):6971–6.PubMed
56.
go back to reference Ramanathan RK et al. A phase II study of lapatinib in patients with advanced biliary tree and hepatocellular cancer. Cancer Chemother Pharmacol. 2009;64(4):777–83.CrossRefPubMed Ramanathan RK et al. A phase II study of lapatinib in patients with advanced biliary tree and hepatocellular cancer. Cancer Chemother Pharmacol. 2009;64(4):777–83.CrossRefPubMed
58.
go back to reference Quan ZW et al. Association of p53, p16, and vascular endothelial growth factor protein expressions with the prognosis and metastasis of gallbladder cancer. J Am Coll Surg. 2001;193(4):380–3.CrossRefPubMed Quan ZW et al. Association of p53, p16, and vascular endothelial growth factor protein expressions with the prognosis and metastasis of gallbladder cancer. J Am Coll Surg. 2001;193(4):380–3.CrossRefPubMed
59.
go back to reference Zhu AX et al. Efficacy and safety of gemcitabine, oxaliplatin, and bevacizumab in advanced biliary-tract cancers and correlation of changes in 18-fluorodeoxyglucose PET with clinical outcome: a phase 2 study. Lancet Oncol. 2010;11(1):48–54.CrossRefPubMed Zhu AX et al. Efficacy and safety of gemcitabine, oxaliplatin, and bevacizumab in advanced biliary-tract cancers and correlation of changes in 18-fluorodeoxyglucose PET with clinical outcome: a phase 2 study. Lancet Oncol. 2010;11(1):48–54.CrossRefPubMed
60.
go back to reference Iyer RV, et al. Gemcitabine (G), capecitabine (C) and bevacizumab (BV) in patients with advanced biliary cancers (ABC): final results of a multicenter phase II study. J Clin Oncol, 2015. 33(15_suppl: abstr #4078). Iyer RV, et al. Gemcitabine (G), capecitabine (C) and bevacizumab (BV) in patients with advanced biliary cancers (ABC): final results of a multicenter phase II study. J Clin Oncol, 2015. 33(15_suppl: abstr #4078).
61.
go back to reference Wedge SR et al. AZD2171: a highly potent, orally bioavailable, vascular endothelial growth factor receptor-2 tyrosine kinase inhibitor for the treatment of cancer. Cancer Res. 2005;65(10):4389–400.CrossRefPubMed Wedge SR et al. AZD2171: a highly potent, orally bioavailable, vascular endothelial growth factor receptor-2 tyrosine kinase inhibitor for the treatment of cancer. Cancer Res. 2005;65(10):4389–400.CrossRefPubMed
62.
go back to reference Benckert C et al. Transforming growth factor beta 1 stimulates vascular endothelial growth factor gene transcription in human cholangiocellular carcinoma cells. Cancer Res. 2003;63(5):1083–92.PubMed Benckert C et al. Transforming growth factor beta 1 stimulates vascular endothelial growth factor gene transcription in human cholangiocellular carcinoma cells. Cancer Res. 2003;63(5):1083–92.PubMed
63.•
go back to reference Valle J, et al. ABC-03: a randomized phase II trial of cediranib (AZD2171) or placebo in combination with cisplatin/gemcitabine (CisGem) chemotherapy for patients (pts) with advanced biliary tract cancer (ABC). J Clin Oncol, 2014. 32(15_suppl: abstr #4002). A randomized phase II trial evaluating the role of cediranib in combination with gemcitabine/cisplatin in advanced BTC. Valle J, et al. ABC-03: a randomized phase II trial of cediranib (AZD2171) or placebo in combination with cisplatin/gemcitabine (CisGem) chemotherapy for patients (pts) with advanced biliary tract cancer (ABC). J Clin Oncol, 2014. 32(15_suppl: abstr #4002). A randomized phase II trial evaluating the role of cediranib in combination with gemcitabine/cisplatin in advanced BTC.
64.
go back to reference ClinicalTrials.gov (NCT01229111), Cediranib maleate and combination chemotherapy in treating patients with advanced biliary cancers. ClinicalTrials.gov (NCT01229111), Cediranib maleate and combination chemotherapy in treating patients with advanced biliary cancers.
65.
go back to reference Keating GM, Santoro A. Sorafenib: a review of its use in advanced hepatocellular carcinoma. Drugs. 2009;69(2):223–40.CrossRefPubMed Keating GM, Santoro A. Sorafenib: a review of its use in advanced hepatocellular carcinoma. Drugs. 2009;69(2):223–40.CrossRefPubMed
67.
go back to reference El-Khoueiry AB et al. SWOG 0514: a phase II study of sorafenib in patients with unresectable or metastatic gallbladder carcinoma and cholangiocarcinoma. Investig New Drugs. 2012;30(4):1646–51.CrossRef El-Khoueiry AB et al. SWOG 0514: a phase II study of sorafenib in patients with unresectable or metastatic gallbladder carcinoma and cholangiocarcinoma. Investig New Drugs. 2012;30(4):1646–51.CrossRef
68.
go back to reference Moehler M et al. Gemcitabine plus sorafenib versus gemcitabine alone in advanced biliary tract cancer: a double-blind placebo-controlled multicentre phase II AIO study with biomarker and serum programme. Eur J Cancer. 2014;50(18):3125–35.CrossRefPubMed Moehler M et al. Gemcitabine plus sorafenib versus gemcitabine alone in advanced biliary tract cancer: a double-blind placebo-controlled multicentre phase II AIO study with biomarker and serum programme. Eur J Cancer. 2014;50(18):3125–35.CrossRefPubMed
69.
go back to reference Krege S et al. Prospective randomized double-blind multicentre phase II study comparing gemcitabine and cisplatin plus sorafenib chemotherapy with gemcitabine and cisplatin plus placebo in locally advanced and/or metastasized urothelial cancer: SUSE (AUO-AB 31/05). BJU Int. 2014;113(3):429–36.CrossRefPubMed Krege S et al. Prospective randomized double-blind multicentre phase II study comparing gemcitabine and cisplatin plus sorafenib chemotherapy with gemcitabine and cisplatin plus placebo in locally advanced and/or metastasized urothelial cancer: SUSE (AUO-AB 31/05). BJU Int. 2014;113(3):429–36.CrossRefPubMed
70.
go back to reference Lee JK et al. A phase II study of gemcitabine and cisplatin plus sorafenib in patients with advanced biliary adenocarcinomas. Br J Cancer. 2013;109(4):915–9.PubMedCentralCrossRefPubMed Lee JK et al. A phase II study of gemcitabine and cisplatin plus sorafenib in patients with advanced biliary adenocarcinomas. Br J Cancer. 2013;109(4):915–9.PubMedCentralCrossRefPubMed
72.
go back to reference Yi JH et al. A phase II study of sunitinib as a second-line treatment in advanced biliary tract carcinoma: a multicentre, multinational study. Eur J Cancer. 2012;48(2):196–201.CrossRefPubMed Yi JH et al. A phase II study of sunitinib as a second-line treatment in advanced biliary tract carcinoma: a multicentre, multinational study. Eur J Cancer. 2012;48(2):196–201.CrossRefPubMed
73.•
go back to reference Santoro A et al. A randomized, multicenter, phase II study of vandetanib monotherapy versus vandetanib in combination with gemcitabine versus gemcitabine plus placebo in subjects with advanced biliary tract cancer: the VanGogh study. Ann Oncol. 2015;26(3):542–7. A randomized phase II trial evaluating the role of vandetanib monotherapy or in combination with gemcitabine.CrossRefPubMed Santoro A et al. A randomized, multicenter, phase II study of vandetanib monotherapy versus vandetanib in combination with gemcitabine versus gemcitabine plus placebo in subjects with advanced biliary tract cancer: the VanGogh study. Ann Oncol. 2015;26(3):542–7. A randomized phase II trial evaluating the role of vandetanib monotherapy or in combination with gemcitabine.CrossRefPubMed
74.
go back to reference Wellbrock C, Karasarides M, Marais R. The RAF proteins take centre stage. Nat Rev Mol Cell Biol. 2004;5(11):875–85.CrossRefPubMed Wellbrock C, Karasarides M, Marais R. The RAF proteins take centre stage. Nat Rev Mol Cell Biol. 2004;5(11):875–85.CrossRefPubMed
75.
go back to reference Khokhlatchev AV et al. Phosphorylation of the MAP kinase ERK2 promotes its homodimerization and nuclear translocation. Cell. 1998;93(4):605–15.CrossRefPubMed Khokhlatchev AV et al. Phosphorylation of the MAP kinase ERK2 promotes its homodimerization and nuclear translocation. Cell. 1998;93(4):605–15.CrossRefPubMed
78.
go back to reference Bekaii-Saab T et al. Multi-institutional phase II study of selumetinib in patients with metastatic biliary cancers. J Clin Oncol. 2011;29(17):2357–63.PubMedCentralCrossRefPubMed Bekaii-Saab T et al. Multi-institutional phase II study of selumetinib in patients with metastatic biliary cancers. J Clin Oncol. 2011;29(17):2357–63.PubMedCentralCrossRefPubMed
79.
go back to reference Finn RS, et al. A phase I study of MEK inhibitor MEK162 (ARRY-438162) in patients with biliary tract cancer. J Clin Oncol, 2012. 30(4_suppl: abstr #220). Finn RS, et al. A phase I study of MEK inhibitor MEK162 (ARRY-438162) in patients with biliary tract cancer. J Clin Oncol, 2012. 30(4_suppl: abstr #220).
80.
go back to reference Lowery MA, et al. A phase I trial of binimetinib in combination with gemcitabine (G) and cisplatin (C) patients (pts) with untreated advanced biliary cancer (ABC). J Clin Oncol, 2015. 33(15_suppl: abstr #e15125). Lowery MA, et al. A phase I trial of binimetinib in combination with gemcitabine (G) and cisplatin (C) patients (pts) with untreated advanced biliary cancer (ABC). J Clin Oncol, 2015. 33(15_suppl: abstr #e15125).
83.
go back to reference Lebwohl D et al. Development of everolimus, a novel oral mTOR inhibitor, across a spectrum of diseases. Ann N Y Acad Sci. 2013;1291:14–32.CrossRefPubMed Lebwohl D et al. Development of everolimus, a novel oral mTOR inhibitor, across a spectrum of diseases. Ann N Y Acad Sci. 2013;1291:14–32.CrossRefPubMed
84.
go back to reference Buzzoni R et al. Activity and safety of RAD001 (everolimus) in patients affected by biliary tract cancer progressing after prior chemotherapy: a phase II ITMO study. Ann Oncol. 2014;25(8):1597–603.CrossRefPubMed Buzzoni R et al. Activity and safety of RAD001 (everolimus) in patients affected by biliary tract cancer progressing after prior chemotherapy: a phase II ITMO study. Ann Oncol. 2014;25(8):1597–603.CrossRefPubMed
85.
go back to reference Yeung YH, et al. Phase II study of everolimus monotherapy as first-line treatment in advanced biliary tract cancer: RADichol. J Clin Oncol, 2014. 32(15_suppl: abstr #4101). Yeung YH, et al. Phase II study of everolimus monotherapy as first-line treatment in advanced biliary tract cancer: RADichol. J Clin Oncol, 2014. 32(15_suppl: abstr #4101).
86.
go back to reference Chen MH et al. Antitumor activity of the combination of an HSP90 inhibitor and a PI3K/mTOR dual inhibitor against cholangiocarcinoma. Oncotarget. 2014;5(9):2372–89.PubMedCentralCrossRefPubMed Chen MH et al. Antitumor activity of the combination of an HSP90 inhibitor and a PI3K/mTOR dual inhibitor against cholangiocarcinoma. Oncotarget. 2014;5(9):2372–89.PubMedCentralCrossRefPubMed
87.
88.
go back to reference Gailani MR et al. The role of the human homologue of Drosophila patched in sporadic basal cell carcinomas. Nat Genet. 1996;14(1):78–81.CrossRefPubMed Gailani MR et al. The role of the human homologue of Drosophila patched in sporadic basal cell carcinomas. Nat Genet. 1996;14(1):78–81.CrossRefPubMed
89.
go back to reference ClinicalTrials.gov (NCT01546519). A study of the Hedgehog pathway inhibitor vismodegib in patients with advanced solid malignancies including hepatocellular carcinoma with varying degrees of renal or hepatic function. clinical trials.gov. ClinicalTrials.gov (NCT01546519). A study of the Hedgehog pathway inhibitor vismodegib in patients with advanced solid malignancies including hepatocellular carcinoma with varying degrees of renal or hepatic function. clinical trials.gov.
90.
go back to reference Jinawath A et al. Dual blockade of the Hedgehog and ERK1/2 pathways coordinately decreases proliferation and survival of cholangiocarcinoma cells. J Cancer Res Clin Oncol. 2007;133(4):271–8.CrossRefPubMed Jinawath A et al. Dual blockade of the Hedgehog and ERK1/2 pathways coordinately decreases proliferation and survival of cholangiocarcinoma cells. J Cancer Res Clin Oncol. 2007;133(4):271–8.CrossRefPubMed
93.
go back to reference Yoon HA et al. Clinicopathological significance of altered Notch signaling in extrahepatic cholangiocarcinoma and gallbladder carcinoma. World J Gastroenterol. 2011;17(35):4023–30.PubMedCentralCrossRefPubMed Yoon HA et al. Clinicopathological significance of altered Notch signaling in extrahepatic cholangiocarcinoma and gallbladder carcinoma. World J Gastroenterol. 2011;17(35):4023–30.PubMedCentralCrossRefPubMed
94.
95.
go back to reference Yamamoto K et al. MUC1 peptide vaccination in patients with advanced pancreas or biliary tract cancer. Anticancer Res. 2005;25(5):3575–9.PubMed Yamamoto K et al. MUC1 peptide vaccination in patients with advanced pancreas or biliary tract cancer. Anticancer Res. 2005;25(5):3575–9.PubMed
96.
go back to reference Lepisto AJ et al. A phase I/II study of a MUC1 peptide pulsed autologous dendritic cell vaccine as adjuvant therapy in patients with resected pancreatic and biliary tumors. Cancer Ther. 2008;6(B):955–64.PubMedCentralPubMed Lepisto AJ et al. A phase I/II study of a MUC1 peptide pulsed autologous dendritic cell vaccine as adjuvant therapy in patients with resected pancreatic and biliary tumors. Cancer Ther. 2008;6(B):955–64.PubMedCentralPubMed
97.
go back to reference Shimizu K et al. Clinical utilization of postoperative dendritic cell vaccine plus activated T-cell transfer in patients with intrahepatic cholangiocarcinoma. J Hepatobiliary Pancreat Sci. 2012;19(2):171–8.CrossRefPubMed Shimizu K et al. Clinical utilization of postoperative dendritic cell vaccine plus activated T-cell transfer in patients with intrahepatic cholangiocarcinoma. J Hepatobiliary Pancreat Sci. 2012;19(2):171–8.CrossRefPubMed
99.
go back to reference Haga H, Patel T. Molecular diagnosis of intrahepatic cholangiocarcinoma. J Hepatobiliary Pancreat Sci. 2015;22(2):114–23.CrossRefPubMed Haga H, Patel T. Molecular diagnosis of intrahepatic cholangiocarcinoma. J Hepatobiliary Pancreat Sci. 2015;22(2):114–23.CrossRefPubMed
100.
go back to reference Arai Y et al. Fibroblast growth factor receptor 2 tyrosine kinase fusions define a unique molecular subtype of cholangiocarcinoma. Hepatology. 2014;59(4):1427–34.CrossRefPubMed Arai Y et al. Fibroblast growth factor receptor 2 tyrosine kinase fusions define a unique molecular subtype of cholangiocarcinoma. Hepatology. 2014;59(4):1427–34.CrossRefPubMed
101.
go back to reference ClinicalTrials.gov (NCT02150967). A phase ii, single arm study of BGJ398 in patients with advanced cholangiocarcinoma. ClinicalTrials.gov (NCT02150967). A phase ii, single arm study of BGJ398 in patients with advanced cholangiocarcinoma.
102.•
go back to reference Borger DR et al. Frequent mutation of isocitrate dehydrogenase (IDH)1 and IDH2 in cholangiocarcinoma identified through broad-based tumor genotyping. Oncologist. 2012;17(1):72–9. Presence of IDH mutations identifies a new target for therapy in IHCC.PubMedCentralCrossRefPubMed Borger DR et al. Frequent mutation of isocitrate dehydrogenase (IDH)1 and IDH2 in cholangiocarcinoma identified through broad-based tumor genotyping. Oncologist. 2012;17(1):72–9. Presence of IDH mutations identifies a new target for therapy in IHCC.PubMedCentralCrossRefPubMed
103.
go back to reference ClinicalTrials.gov (NCT02481154). Study of orally administered AG-881 in patients with advanced solid tumors, including gliomas, with an IDH1 and/or IDH2 mutation. ClinicalTrials.gov (NCT02481154). Study of orally administered AG-881 in patients with advanced solid tumors, including gliomas, with an IDH1 and/or IDH2 mutation.
104.
go back to reference ClinicalTrials.gov (NCT02073994). Study of orally administered AG-120 in subjects with advanced solid tumors, including glioma, with an IDH1 mutation. ClinicalTrials.gov (NCT02073994). Study of orally administered AG-120 in subjects with advanced solid tumors, including glioma, with an IDH1 mutation.
105.
go back to reference Ocean AJ et al. Phase II trial of the ribonucleotide reductase inhibitor 3-aminopyridine-2-carboxaldehydethiosemicarbazone plus gemcitabine in patients with advanced biliary tract cancer. Cancer Chemother Pharmacol. 2011;68(2):379–88.PubMedCentralCrossRefPubMed Ocean AJ et al. Phase II trial of the ribonucleotide reductase inhibitor 3-aminopyridine-2-carboxaldehydethiosemicarbazone plus gemcitabine in patients with advanced biliary tract cancer. Cancer Chemother Pharmacol. 2011;68(2):379–88.PubMedCentralCrossRefPubMed
106.
go back to reference Zhang LQ et al. Potential therapeutic targets for the primary gallbladder carcinoma: estrogen receptors. Asian Pac J Cancer Prev. 2013;14(4):2185–90.CrossRefPubMed Zhang LQ et al. Potential therapeutic targets for the primary gallbladder carcinoma: estrogen receptors. Asian Pac J Cancer Prev. 2013;14(4):2185–90.CrossRefPubMed
Metadata
Title
Targeted Therapy in Biliary Tract Cancers
Authors
Amartej Merla, MD
Kenneth G. Liu, MD
Lakshmi Rajdev, MD
Publication date
01-10-2015
Publisher
Springer US
Published in
Current Treatment Options in Oncology / Issue 10/2015
Print ISSN: 1527-2729
Electronic ISSN: 1534-6277
DOI
https://doi.org/10.1007/s11864-015-0366-0

Other articles of this Issue 10/2015

Current Treatment Options in Oncology 10/2015 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine