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Current Oncology
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Biliary Tract Cancer Updates: Advancements and Insights
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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: 15 March 2026 | Viewed by 6690

Special Issue Editor

Dr. Kristen R. Spencer

E-Mail Website
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

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Current Oncology is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

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

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Published Papers (6 papers)

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Research

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17 pages, 1929 KiB  
Article
Prognostic Factors and Treatment Outcomes in Gallbladder Cancer Patients Undergoing Curative Surgery: A Multicenter Retrospective Cohort Study
by Bowen Xu, Yanjiang Yin, Jianping Chang, Zhiyu Li, Xinyu Bi, Jianqiang Cai and Xiao Chen
Curr. Oncol. 2025, 32(6), 328; https://doi.org/10.3390/curroncol32060328 - 3 Jun 2025
Viewed by 348
Abstract
Background: Gallbladder cancer (GBC) is a highly aggressive malignancy often diagnosed at an advanced stage due to its asymptomatic onset. Despite surgery being the only potentially curative option, recurrence and poor prognosis remain common, especially in advanced-stage diseases. There is limited consensus regarding [...] Read more.
Background: Gallbladder cancer (GBC) is a highly aggressive malignancy often diagnosed at an advanced stage due to its asymptomatic onset. Despite surgery being the only potentially curative option, recurrence and poor prognosis remain common, especially in advanced-stage diseases. There is limited consensus regarding the extent of lymphadenectomy, hepatic resection, and the role of adjuvant therapies. Identifying prognostic factors and optimizing treatment strategies are critical for improving outcomes. This multicenter retrospective study was conducted to evaluate the clinical and pathological predictors of survival and recurrence in GBC patients that underwent radical surgery and to assess the potential benefit of adjuvant therapies in advanced stages. Methods: This was a retrospective cohort study of GBC patients who underwent curative-intent resection for GBC between 2010 and 2022 at two tertiary medical centers in China. The baseline characteristics, surgical data, pathology, adjuvant therapy, and follow-up outcomes were analyzed. The survival outcomes were assessed using Kaplan–Meier methods and Cox regression models. Subgroup analyses were conducted to explore the impact of postoperative adjuvant chemotherapy, period of surgical treatment, and extent of resection. Multiple imputation was used to address missing data. Results: The 5-year overall survival (OS) rate was 57.4%. Independent predictors of a poorer OS included CA19-9 > 30 U/mL (HR = 1.861, p = 0.003), poor/moderate-to-poor differentiation (HR = 2.134, p = 0.004), T3–T4 stage (HR = 2.685, p = 0.001), N1–N2 stage (HR = 2.217, p = 0.002), M1 stage (HR = 2.308, p = 0.001), and a high CAN score (HR = 1.875, p = 0.009). Adjuvant chemotherapy improved the OS in the stage III–IV patients (24.8 vs. 17.3 months, p = 0.036), though the DFS improvement was not significant (p = 0.133). No survival difference was observed between the segment IVb + V resection and wedge resection in the T2b patients. The patients treated after 2017 had a better OS (p = 0.024), possibly due to improved surgical techniques and perioperative care. Conclusions: Radical surgery remains critical for GBC. Accurate staging and tailored perioperative strategies, including chemotherapy, may improve outcomes, though further prospective 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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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
Viewed by 445
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
Viewed by 453
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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18 pages, 361 KiB  
Review
Therapeutic Advances in Initially Unresectable Locally Advanced Intrahepatic Cholangiocarcinoma: Emerging Treatments and the Role of Liver Transplantation
by Sofia Lopiano, James V. Guarrera and Keri E. Lunsford
Curr. Oncol. 2025, 32(6), 293; https://doi.org/10.3390/curroncol32060293 - 22 May 2025
Viewed by 415
Abstract
Optimal curative therapy for intrahepatic cholangiocarcinoma (iCCA) involves hepatic resection; however, due to its insidious nature, iCCA frequently presents at advanced stages. Consequently, 70–80% of patients feature unresectable iCCA at presentation. Recent expansions in therapeutic options for locally advanced unresectable iCCA include immunotherapy, [...] Read more.
Optimal curative therapy for intrahepatic cholangiocarcinoma (iCCA) involves hepatic resection; however, due to its insidious nature, iCCA frequently presents at advanced stages. Consequently, 70–80% of patients feature unresectable iCCA at presentation. Recent expansions in therapeutic options for locally advanced unresectable iCCA include immunotherapy, targeted chemotherapeutics, and liver-directed therapies. These have increased progression-free survival, enhanced response rates, and improved downstaging for resection. Liver transplant has also emerged as an alternative for patients whose tumors remain unresectable despite therapeutic response. Here, we explore emerging treatment options included in a multidisciplinary treatment paradigm to prolong survival in patients with initially unresectable locally advanced iCCA. Full article
(This article belongs to the Special Issue Biliary Tract Cancer Updates: Advancements and Insights)
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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
Cited by 1 | Viewed by 2022
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
Viewed by 2212
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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