Preoperative and postoperative chemotherapy for biliary tract cancers and chemotherapy for unresected advanced biliary tract cancers

Abstract

Surgical resection is the only radical treatment for bile duct cancer. However, it is often discovered in an advanced and unresectable state, either because it is advanced cancer at the time of diagnosis or because of extensive invasion or distant metastasis. Chemotherapy is performed after resection or in unresectable cases. In Japan, the standard first-line therapy for unresectable bile duct cancer is combination therapy with gemcitabine plus cisplatin. S-1 is often used as second-line therapy, but evidence for it has not been established, including in an adjuvant chemotherapy for bile duct cancer. Chemotherapy in resectable cases and conversion therapy in unresectable cases is sought through trial and error. The results of currently ongoing prospective trials are awaited. Advances in biomarkers to predict the outcome following chemotherapy and in personalized medicine are also anticipated.