Adjuvant therapy for resected biliary tract cancer

Abstract

Recently, three randomized controlled trials of adjuvant chemotherapy in patients with biliary tract cancer were presented (PRODIGE12-ACCORD18, BCAT, BILCAP). Unfortunately, these studies failed to show the survival benefit in intent-to-treat analysis. Although the BILAP trial demonstrated a longer survival time in the capecitabine group compared with the observation group in per-protocol analysis, this result could not change the statements of the NCCN guidelines. The benefit of adjuvant (chemo-) radiotherapy for biliary tract cancer remains controversial, too. Due to the lack of randomized trials, available data comes from single center experiences or data-based population studies with inconclusive result. Therefore, to assess the impact of adjuvant (chemo-) radiotherapy, further clinical trials should instead focus on patients with high-risk features.