Paradigm shift of chemotherapy and systemic treatment for biliary tract cancer

doi:10.4251/wjgo.v15.i6.959

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Jun 15, 2023 (publication date) through Feb 15, 2026

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World Journal of Gastrointestinal Oncology

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World J Gastrointest Oncol. Jun 15, 2023; 15(6): 959-972
Published online Jun 15, 2023. doi: 10.4251/wjgo.v15.i6.959

Paradigm shift of chemotherapy and systemic treatment for biliary tract cancer

Wattana Leowattana, Tawithep Leowattana, Pathomthep Leowattana

Wattana Leowattana, Pathomthep Leowattana, Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Rachatawee 10400, Bangkok, Thailand

Tawithep Leowattana, Department of Medicine, Faculty of Medicine, Srinakharinwirot University, Wattana 10110, Bangkok, Thailand

Author contributions: Leowattana W wrote the paper; Leowattana T and Leowattana P collected the data.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Corresponding author: Wattana Leowattana, BMed, MD, MSc, PhD, Full Professor, Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, 420/6 Rajavithi Road, Rachatawee 10400, Bangkok, Thailand. wattana.leo@mahidol.ac.th

Received: January 26, 2023
Peer-review started: January 26, 2023
First decision: April 11, 2023
Revised: April 14, 2023
Accepted: May 5, 2023
Article in press: May 5, 2023
Published online: June 15, 2023
Processing time: 139 Days and 17.7 Hours

Core Tip

Core Tip: There have been several developments in the field of advanced biliary tract cancer (BTC) therapy in recent years. First, the care of these hepatobiliary malignancies has improved as a result of better knowledge of the molecular basis of BTC. The Food and Drug Administration's approval of pemigatinib, infigratinib, and ivosidenib for fibroblast growth factor receptor 2-rearranged and isocitrate dehydrogenase 1-mutant cholangiocarcinoma illustrates the paradigm shift that the arrival of targeted agents has really brought about. Second, patients receiving modified fluorouracil, oxaliplatin, and liposomal irinotecan with fluorouracil-leucovorin, respectively, as second-line treatments after progressing to first-line cisplatin-gemcitabine, showed an overall survival advantage in the newly released Advanced Biliary Tract Cancer-06 and NIFTY studies.