Biliary Tract Cancer Updates: Advancements and Insights

A special issue of Current Oncology (ISSN 1718-7729). This special issue belongs to the section "Gastrointestinal Oncology".

Deadline for manuscript submissions: 30 June 2025 | Viewed by 4187

Special Issue Editor


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Guest Editor
Department of Medicine, Perlmutter Cancer Center of NYU Langone Health and NYU Grossman School of Medicine, New York, NY 10016, USA
Interests: bile duct cancer; biliary cancer; colorectal cancer; gastrointestinal cancer; gastrointestinal neuroendocrine tumor; liver cancer; pancreatic cancer

Special Issue Information

Dear Colleagues,

Welcome to the inaugural edition of “Biliary Tract Cancer Updates: Advancements and Insights”. Biliary tract cancers, encompassing malignancies of the bile ducts, gallbladder, and ampulla of Vater, present formidable challenges in diagnosis, treatment, and management. Despite recent advances, these cancers remain notoriously difficult to detect at early stages and in advanced stages continue to pose significant clinical dilemmas that necessitate novel approaches to management. This Special Issue of Current Oncology serves as a platform for disseminating cutting-edge research, clinical breakthroughs, and multidisciplinary perspectives in this rapidly evolving field. With this Special Issue, we aim to bridge the gap between scientific discoveries and clinical practice by providing comprehensive updates on the latest developments in biliary tract cancer research and practice. Moreover, “Biliary Tract Cancer Updates” serves as a collaborative platform for researchers, clinicians, pathologists, and allied healthcare professionals to contribute to the collective knowledge base in this specialized field. We invite submissions from researchers and clinicians across diverse disciplines to contribute their original research, clinical insights, and perspectives to this Special Issue. Together, let us explore new horizons and pave the way for groundbreaking advancements in patient care.

Thank you for joining us on this journey of discovery and innovation in the fight against biliary tract cancers!

Warm Regards,

Dr. Kristen R. Spencer
Guest Editor

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Keywords

  • biliary tract cancer
  • intrahepatic cholangiocarcinoma
  • extrahepatic cholangiocarcinoma
  • gallbladder cancer
  • targeted therapy
  • immunotherapy
  • molecular profiling
  • clinical trials

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Published Papers (4 papers)

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Research

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13 pages, 1122 KiB  
Article
A New Prognostic Indicator for Biliary Tract Cancers: The ABIC Score
by Doğan Bayram, Öznur Bal, Kemal Karaman, Murat Bardakçı, Derya Demirtaş Esmer, İsmet Seven, Serhat Sekmek, Perihan Perkin, Fahriye Tuğba Köş, Efnan Algın and Doğan Uncu
Curr. Oncol. 2025, 32(4), 200; https://doi.org/10.3390/curroncol32040200 - 28 Mar 2025
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Abstract
Introduction: Biliary tract cancers (BTC) comprise a heterogeneous group of malignancies, including gallbladder cancer, intrahepatic cholangiocarcinoma, and extrahepatic cholangiocarcinoma. The main determinants of prognosis in BTC are the stage of the disease and the eligibility for curative treatment. Additionally, liver functional capacity is [...] Read more.
Introduction: Biliary tract cancers (BTC) comprise a heterogeneous group of malignancies, including gallbladder cancer, intrahepatic cholangiocarcinoma, and extrahepatic cholangiocarcinoma. The main determinants of prognosis in BTC are the stage of the disease and the eligibility for curative treatment. Additionally, liver functional capacity is also one of the factors influencing survival in biliary tract cancers. The age–bilirubin–INR–creatinine (ABIC) score has been previously shown to predict prognosis in hepatic diseases. The aim of our study is to demonstrate the relationship between the ABIC score and prognosis in BTC. Materials and Methods: In this study, a retrospective analysis was performed on 41 patients with non-metastatic BTC and 73 patients with metastatic BTC who were followed up in our clinic between 2003 and 2025. All patients were ≥18 years old at the time of diagnosis, and BTC was pathologically confirmed. The ABIC score was calculated separately for each group. A threshold value for the ABIC score was determined using Receiver Operating Characteristic (ROC) analysis, and based on this threshold, patients were divided into low and high ABIC score groups. Both the relationship between the ABIC score and prognosis and the other factors affecting prognosis were investigated. Results: In the non-metastatic BTC group, the cutoff value for the ABIC score was 6.89. The median survival time of patients with a high ABIC score was significantly shorter. In the metastatic BTC group, the cutoff value for the ABIC score was 7.41. Similarly, in this group, patients with a high ABIC score had a significantly shorter median survival time. Additionally, in the non-metastatic BTC group, tumor localization and stage were prognostic factors affecting survival, while in the metastatic BTC group, CEA and first-line chemotherapy were the prognostic factors influencing overall survival. Conclusions: We demonstrate that the ABIC score is a prognostic factor determining median survival in both non-metastatic and metastatic BTC patients. Full article
(This article belongs to the Special Issue Biliary Tract Cancer Updates: Advancements and Insights)
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12 pages, 1577 KiB  
Article
Impact of Resection Margins and Adjuvant Therapy on Survival Outcomes in Lymph Node-Negative Distal Cholangiocarcinoma
by Hye Jin Kang and In Young Jo
Curr. Oncol. 2025, 32(3), 178; https://doi.org/10.3390/curroncol32030178 - 19 Mar 2025
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Abstract
The prognostic value of the resection margin (RM) status and the efficacy of adjuvant therapy (AT) in distal cholangiocarcinoma (CCC) are unclear. RM status appears particularly impactful in lymph node-negative distal CCC, representing early-stage disease. The prognostic value of RM status was investigated, [...] Read more.
The prognostic value of the resection margin (RM) status and the efficacy of adjuvant therapy (AT) in distal cholangiocarcinoma (CCC) are unclear. RM status appears particularly impactful in lymph node-negative distal CCC, representing early-stage disease. The prognostic value of RM status was investigated, and subpopulations of patients with lymph node-negative distal CCC who might benefit from AT were identified. Overall, 139 patients with distal CCC who underwent surgical resection between March 2006 and December 2023 were analyzed. RM status was categorized as wide (>5 mm) in 65 patients (46.8%), close (≤5 mm) in 32 patients (23.0%), or positive in 42 patients (30.2%). AT was administered to 48 patients (34.5%). Patients with close or positive RMs achieved significantly lower locoregional control (LRC) than those with wide RMs. However, overall survival (OS) did not differ across the three RM groups. The impact of RM status was more evident in patients not receiving AT. Patients with wide RMs exhibited better 3-year LRC, progression-free survival (PFS), and OS rates (79.0%, 66.5%, and 69.1%, respectively) than those with close (21.7%, 15.7%, and 34.4%) or positive RMs (44.3%, 25.3%, and 50.2%, respectively). No significant differences were found between close and positive RM groups. AT appears to have improved LRC and PFS in patients with close or positive RMs but not in those with wide RMs. Close RMs were associated with poor outcomes comparable to those with positive RMs. These results indicate that achieving adequate RM width is crucial for improving survival. Moreover, AT may improve survival when adequate RMs cannot be achieved. Nonetheless, larger studies are needed to validate these findings. Full article
(This article belongs to the Special Issue Biliary Tract Cancer Updates: Advancements and Insights)
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Review

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22 pages, 309 KiB  
Review
Advancements in Locoregional Therapies for Unresectable Intrahepatic Cholangiocarcinoma
by Conor D. J. O’Donnell, Umair Majeed, Michael S. Rutenberg, Kristopher P. Croome, Katherine E. Poruk, Beau Toskich and Zhaohui Jin
Curr. Oncol. 2025, 32(2), 82; https://doi.org/10.3390/curroncol32020082 - 31 Jan 2025
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Abstract
Intrahepatic cholangiocarcinoma is an aggressive malignancy with rising incidence and poor outcomes. This review examines recent advancements in locoregional therapies for unresectable intrahepatic cholangiocarcinoma, focusing on external beam radiotherapy, transarterial radioembolization (TARE), hepatic artery infusion pump (HAIP) chemotherapy, and liver transplantation. Stereotactic body [...] Read more.
Intrahepatic cholangiocarcinoma is an aggressive malignancy with rising incidence and poor outcomes. This review examines recent advancements in locoregional therapies for unresectable intrahepatic cholangiocarcinoma, focusing on external beam radiotherapy, transarterial radioembolization (TARE), hepatic artery infusion pump (HAIP) chemotherapy, and liver transplantation. Stereotactic body radiation therapy and proton beam therapy have shown promise in achieving local control and improving survival. TARE, with personalized dosimetry, has demonstrated encouraging results in select patient populations. HAIP chemotherapy, primarily studied using floxuridine, has yielded impressive survival outcomes in phase II trials. Liver transplantation, once contraindicated, is now being reconsidered for carefully selected patients with localized disease. While these locoregional approaches show potential, randomized controlled trials comparing them to standard systemic therapy are lacking. Patient selection remains crucial, with factors such as liver function, tumor burden, and molecular profile influencing treatment decisions. Ongoing research aims to optimize treatment sequencing, explore combination strategies with systemic therapies, and refine phenotype identification and patient selection criteria. As the landscape of intrahepatic cholangiocarcinoma management evolves, a multidisciplinary approach is essential to tailor treatment strategies and improve outcomes for patients with this challenging disease. Full article
(This article belongs to the Special Issue Biliary Tract Cancer Updates: Advancements and Insights)
17 pages, 762 KiB  
Review
IDH Mutant Cholangiocarcinoma: Pathogenesis, Management, and Future Therapies
by Alexander Bray and Vaibhav Sahai
Curr. Oncol. 2025, 32(1), 44; https://doi.org/10.3390/curroncol32010044 - 17 Jan 2025
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Abstract
Mutations in isocitrate dehydrogenase (IDH) genes are among the most frequently encountered molecular alterations in cholangiocarcinoma (CCA). These neomorphic point mutations endow mutant IDH (mIDH) with the ability to generate an R-enantiomer of 2-hydroxyglutarate (R2HG), a metabolite that drives malignant transformation through aberrant [...] Read more.
Mutations in isocitrate dehydrogenase (IDH) genes are among the most frequently encountered molecular alterations in cholangiocarcinoma (CCA). These neomorphic point mutations endow mutant IDH (mIDH) with the ability to generate an R-enantiomer of 2-hydroxyglutarate (R2HG), a metabolite that drives malignant transformation through aberrant epigenetic signaling. As a result, pharmacologic inhibition of mIDH has become an attractive therapeutic strategy in CCAs harboring this mutation. One such inhibitor, ivosidenib, has already undergone clinical validation and received FDA approval in this disease, but there is still much work to be done to improve outcomes in mIDH CCA patients. In this publication we will review the pathogenesis and treatment of mIDH CCA with special emphasis on novel agents and combinations currently under investigation. Full article
(This article belongs to the Special Issue Biliary Tract Cancer Updates: Advancements and Insights)
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