2020 Volume 34 Issue 4 Pages 663-671
Drug therapy plays a major role in the treatment of advanced biliary tract cancer, but its efficacy and treatment option are limited. Therefore, further development is indispensable for improving the overall prognosis of this cancer. Precision medicine, which examines genetic alterations in cancer and treat it with molecular targeted agents, is a new treatment option which is particularly expected for biliary tract cancer. Recently, several FGFR inhibitors and IDH inhibitors showed good efficacies and tolerability for advanced intrahepatic cholangiocarcinoma. In Japan, a cancer multi-gene panel testing has been approved by public insurance, and it is expected that treatment based on genetic alteration will further develop in the field of biliary tract cancer. However, there are many issues that needed to be resolved in the near future, such as the time until the results of genomic testing are obtained, the way to gain a sufficient volume of sample in inoperable cases, the lack of effective therapeutic agents for genetic alterations, and the cost of genomic testing.
