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New Insights into the Management of Intrahepatic Cholangiocarcinoma

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Special Issue Editor

Dr. Gianluca Rompianesi

Department of Clinical Medicine and Surgery, Federico II University Hospital, 80131 Naples, Italy
Interests: surgical oncology; liver cancers; pancreatic cancers; biliary cancers; liver surgery; pancreatic surgery; biliary surgery; minimally invasive surgery; robotic surgery

Special Issue Information

Dear Colleagues,

Intrahepatic cholangiocarcinoma (iCCA) is the second most common primary liver cancer, showing a steady increase in its incidence and mortality over time in most locations worldwide. It appears above the second-order bile ducts and can also present in a mixed form with hepatocellular carcinoma (HCC).

Only a minority of patients diagnosed with iCCA are amenable of surgical resection (<20%), which represents the only curative option, and are still burdened with dismal survival (15-40% at 5 years) and a high recurrence rate.

The diagnostic and therapeutic management of iCCA is complex, due to significant variations in disease course and outcome in relation to tumor stages and different molecular profiling, mandating a multidisciplinary approach involving histopathology, interventional radiology, oncology, surgical oncology, and radiotherapy professionals.

Recently, several genomic and immunohistochemistry biomarkers have been analyzed, risk models and nomograms have been developed, and surgical and non-surgical treatment options have been explored in an effort to guide clinicians to identify the best strategies and improve the prognosis of both patients with resectable and unresectable disease.

Due to such an intricated scenario, this Special Issue aims to focus on the latest advances in iCCA classification, diagnosis, prognosis, and treatments.

Dr. Gianluca Rompianesi
Guest Editor

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Keywords

intrahepatic cholangiocarcinoma
liver cancer
biliary tract neoplasm
diagnosis
therapies
treatment
outcome

Published Papers (2 papers)

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Research

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17 pages, 2938 KiB

Open AccessArticle

Active Autophagy Is Associated with Favorable Outcome in Patients with Surgically Resected Cholangiocarcinoma

by Katrin Bankov, Falko Schulze, Steffen Gretser, Henning Reis, Nada Abedin, Fabian Finkelmeier, Jörg Trojan, Stefan Zeuzem, Andreas A. Schnitzbauer, Dirk Walter, Peter J. Wild and Maximilian N. Kinzler

Cancers 2023, 15(17), 4322; https://doi.org/10.3390/cancers15174322 - 29 Aug 2023

Viewed by 1309

Abstract

Data on the impact of autophagy in primary cholangiocarcinoma (CCA) remain scarce. Here, we therefore investigated the role of active autophagy and its impact on survival in CCA patients. All CCA patients who underwent surgical resection with curative intent between 08/2005 and 12/2021 at University Hospital Frankfurt were evaluated. Autophagic key proteins were studied by immunohistochemistry. iCCA processed for gene expression profiling of immune-exhaustion gene sets was used for an autophagy approach in silico. Active autophagy was present in 23.3% of the 172 CCA patients. Kaplan–Meier curves revealed median OS of 68.4 months (95% CI = 46.9–89.9 months) and 32.7 months (95% CI = 23.6–41.8 months) for active and non-active autophagy, respectively (p ≤ 0.001). In multivariate analysis, absence of active autophagy (HR = 2, 95% CI = 1.1–3.5, p = 0.015) was an independent risk factor for OS. Differential-expression profiling revealed significantly upregulated histone deacetylases (HDAC) mRNA in patients showing non-active autophagy. In line with this, pan-acetylated lysine was significantly more prominent in CCA patients with ongoing autophagy (p = 0.005). Our findings strengthen the role of active autophagy as a prognostically relevant marker and a potential therapeutic target. Full article

(This article belongs to the Special Issue New Insights into the Management of Intrahepatic Cholangiocarcinoma)

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Review

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56 pages, 2661 KiB

Open AccessReview

Current and Future Therapeutic Targets for Directed Molecular Therapies in Cholangiocarcinoma

by Philipp Heumann, Andreas Albert, Karsten Gülow, Denis Tümen, Martina Müller and Arne Kandulski

Cancers 2024, 16(9), 1690; https://doi.org/10.3390/cancers16091690 - 26 Apr 2024

Viewed by 989

Abstract

We conducted a comprehensive review of the current literature of published data, clinical trials (MEDLINE; ncbi.pubmed.com), congress contributions (asco.org; esmo.org), and active recruiting clinical trains (clinicaltrial.gov) on targeted therapies in cholangiocarcinoma. Palliative treatment regimens were analyzed as well as preoperative and perioperative treatment options. We summarized the current knowledge for each mutation and molecular pathway that is or has been under clinical evaluation and discussed the results on the background of current treatment guidelines. We established and recommended targeted treatment options that already exist for second-line settings, including IDH-, BRAF-, and NTRK-mutated tumors, as well as for FGFR2 fusion, HER2/neu-overexpression, and microsatellite instable tumors. Other options for targeted treatment include EGFR- or VEGF-dependent pathways, which are known to be overexpressed or dysregulated in this cancer type and are currently under clinical investigation. Targeted therapy in CCA is a hallmark of individualized medicine as these therapies aim to specifically block pathways that promote cancer cell growth and survival, leading to tumor shrinkage and improved patient outcomes based on the molecular profile of the tumor. Full article

(This article belongs to the Special Issue New Insights into the Management of Intrahepatic Cholangiocarcinoma)

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