Paradigm Shift in Precision Medicine for Unresectable Biliary Cancer

Abstract

Five years have passed since cancer genome profiling (CGP) tests were approved for public insurance coverage in June 2019. The landscape of CGP tests has changed, and five types of CGP tests, including liquid biopsy using blood samples, are now available. Since the prevalence of druggable variants are high in biliary tract cancer, European Society for Medical Oncology (ESMO) recommends routine CGP test for unresectable biliary tract cancer. Currently, six biomarkers (FGFR fusion gene, MSI-H, BRAF V600E, TMB-H, NTRK fusion gene, and RET fusion gene) and matched drugs covered by insurance are available for biliary tract cancer in Japan, and more drugs targeting druggable variants are expected to enter daily clinical practice in the near future.