Italian Clinical Practice Guidelines on Cholangiocarcinoma – Part II: Treatment

Alvaro, Domenico; Hassan, Cesare; Cardinale, Vincenzo; Carpino, Guido; Fabris, Luca; Gringeri, Enrico; Granata, Vincenza; Mutignani, Massimiliano; Morement, Helen; Giuliante, Felice; Guglielmi, Alfredo; Tonini, Giuseppe; Marzioni, Marco; Grazi, Gian Luca; Guido, Maria; Giulio, Emilio Di; Pantano, Francesco; Venere, Rosanna; Bragazzi, Maria Consiglia; Biancanello, Francesca; Faccioli, Jessica; Giannetti, Aurora; Cintolo, Marcello; Giunta, Michela Di; Gambato, Martina; Lasagni, Alberto; Izzo, Francesco; Avallone, Antonio; Rossi, Massimo; Catalano, Carlo; Laghi, Andréa; d’Amati, Giulia; Mancino, Maria Grazia

doi:10.1016/j.dld.2020.08.030

Cited by 43 publications

(18 citation statements)

References 196 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In conclusion, excluding the modest, above-described, therapeutic options, physicians and patients are lacking any further pharmacological strategy. Also, radiation therapy gave inconclusive results in this setting[ 17 ], meaning that current national guidelines are not able to give an unequivocal indication on this approach[ 18 ]. In conclusion, the scarce results of systemic therapy have prompted extensive research in recent decades in order to find a more satisfactory pharmacological approach for this cancer.…”

Section: Cca Pharmacological Treatment: the Presentmentioning

confidence: 99%

Moving forward in the treatment of cholangiocarcinoma

Manzia¹,

Parente²,

Lenci³

et al. 2021

WJGO

View full text Add to dashboard Cite

Despite being the second most frequent primary liver tumor in humans, early diagnosis and treatment of cholangiocarcinoma (CCA) are still unsatisfactory. In fact, survival after 5 years is expected in less than one fourth of patients diagnosed with this disease. Rare incidence, late appearance of symptoms and heterogeneous biology are all factors contributing to our limited knowledge of this cancer and determining its poor prognosis in the clinical setting. Several efforts have been made in the last decades in order to achieve an improved classification/understanding with regard to the diverse CCA forms. Location within the biliary tree has helped to distinguish between intrahepatic, perihilar and distal CCA types. Sequence analysis contributed to identifying several characteristic genetic aberrations in CCA that may also serve as possible targets for therapy. Novel findings are expected to significantly improve the management of this malignancy in the near future. In this changing scenario our review focuses on the current and future strategies for CCA treatment. Both systemic and surgical treatments are discussed in detail. The results of the main studies in this field are reported, together with the ongoing trials. The current findings suggest that an integrated multidisciplinary approach to this malignancy would be helpful to improve its outcome.

show abstract

Section: Cca Pharmacological Treatment: the Presentmentioning

confidence: 99%

Moving forward in the treatment of cholangiocarcinoma

Manzia¹,

Parente²,

Lenci³

et al. 2021

WJGO

View full text Add to dashboard Cite

show abstract

“…The CCA dismal prognosis, with a 5-years survival rate of 7–20% [ 6 ], is worrisome and, together with the increasing incidence reported for iCCA, explains the endeavor to understand their pathobiology, in order to develop more effective therapeutic strategies. In fact, cisplatin–gemcitabine chemotherapy is often the only possible therapeutic option, while, in the event of failure of the first-line regimen, there is still no clear indication of a second-line regimen to date [ 7 ], although promising results have been observed in randomized controlled trials (RCT), e.g., phase II ABC-06 RCT [ 8 ]. Several authors [ 9 , 10 , 11 ] have underlined the need to overcome this oncology-based approach, and clinical trials have explored the possibility of targeted therapies [ 12 , 13 ], revealing the potential of precision medicine in CCA [ 14 , 15 ], defined as tailoring the treatment to the individual characteristics of each patient.…”

Section: Introductionmentioning

confidence: 99%

Molecular Landscape and Therapeutic Strategies in Cholangiocarcinoma: An Integrated Translational Approach towards Precision Medicine

Casadio

Biancaniello

Overi

et al. 2021

IJMS

Self Cite

View full text Add to dashboard Cite

Cholangiocarcinomas (CCAs) are heterogeneous biliary tract malignancies with dismal prognosis, mainly due to tumor aggressiveness, late diagnosis, and poor response to current therapeutic options. High-throughput technologies have been used as a fundamental tool in unveiling CCA molecular landscape, and several molecular classifications have been proposed, leading to various targeted therapy trials. In this review, we aim to analyze the critical issues concerning the status of precision medicine in CCA, discussing molecular signatures and clusters, related to both anatomical classification and different etiopathogenesis, and the latest therapeutic strategies. Furthermore, we propose an integrated approach comprising the CCA molecular mechanism, pathobiology, clinical and histological findings, and treatment perspectives for the ultimate purpose of improving the methods of patient allocations in clinical trials and the response to personalized therapies.

show abstract

“…Intrahepatic cholangiocarcinoma (iCCA) is a relatively rare and highly aggressive form of primary liver tumor, characterized by increasing incidence and mortality rates worldwide, which have given rise to growing scientific interest aimed at better disease classification, molecular diagnostics, and pathology accuracy [ 1 , 2 , 3 , 4 , 5 , 6 , 7 ]. Though radical surgery was once considered the only curative option, considerable efforts have been made in search of protocols and therapeutic schemes to improve the outcome and survival rate in selected patients undergoing liver transplantation (LT), now being considered an appropriate treatment option for cholangiocarcinoma patients [ 8 , 9 , 10 , 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Liver Transplantation for Unresectable Intrahepatic Cholangiocarcinoma: The Role of Sequencing Genetic Profiling

Gruttadauria

Barbera

Pagano

et al. 2021

Cancers

View full text Add to dashboard Cite

Intrahepatic cholangiocarcinoma (iCCA) is a rare and aggressive primary liver tumor, characterized by a range of different clinical manifestations and by increasing incidence and mortality rates even after curative treatment with radical resection. In recent years, growing attention has been devoted to this disease and some evidence supports liver transplantation (LT) as an appropriate treatment for intrahepatic cholangiocarcinoma; evolving work has also provided a framework for better understanding the genetic basis of this cancer. The aim of this study was to provide a clinical description of our series of patients complemented with Next-Generation Sequencing genomic profiling. From 1999 to 2021, 12 patients who underwent LT with either iCCA or a combined hepatocellular and cholangiocellular carcinoma (HCC-iCCA) were included in this study. Mutations were observed in gene activating signaling pathways known to be involved with iCCA tumorigenesis (KRAS/MAPK, P53, PI3K-Akt/mTOR, cAMP, WNT, epigenetic regulation and chromatin remodeling). Among several others, a strong association was observed between the Notch pathway and tumor size (point-biserial rhopb = 0.93). Our results are suggestive of the benefit potentially derived from molecular analysis to improve our diagnostic capabilities and to devise new treatment protocols, and eventually ameliorate long-term survival of patients affected by iCCA or HCC-iCCA.

show abstract

Italian Clinical Practice Guidelines on Cholangiocarcinoma – Part II: Treatment

Cited by 43 publications

References 196 publications

Moving forward in the treatment of cholangiocarcinoma

Moving forward in the treatment of cholangiocarcinoma

Molecular Landscape and Therapeutic Strategies in Cholangiocarcinoma: An Integrated Translational Approach towards Precision Medicine

Liver Transplantation for Unresectable Intrahepatic Cholangiocarcinoma: The Role of Sequencing Genetic Profiling

Contact Info

Product

Resources

About