Integrating Molecular Insights into Biliary Tract Cancer Management: A Review of Personalized Therapeutic Strategies
, Tamara Sauri 1,2,5, Gemma Iserte 2,3,4, Carla Fuster-Anglada 2,3,6, Alba DÃaz 1,2,3,6, Laura Sererols-Viñas 2, Silvia Affo 2 and Alejandro Forner 1,2,3,4,*Round 1
Reviewer 1 Report
Comments and Suggestions for AuthorsThis is an informative review article describing targeted therapeutic approaches for biliary tract cancers based on molecular mutations. Here are the comments.
1. It will be good if the authors could include a table on current FDA approved drugs for biliary tract cancers.
2. It will be informative if the authors could include in Table 2 side effects of the drugs used.
3. Limitations of using only molecular profiling to stratify biliary tract cancer patients for therapy could be discussed.
4. Other than molecular profiling, epigenetic modifications in biliary tract cancers may also be leveraged for personalized medicine e.g. EZH2, DNA methylation inhibitors. Please discuss.
5. Figure legends missing.
Author Response
"Please see the attachment."
Author Response File: 
Author Response.pdf
Reviewer 2 Report
Comments and Suggestions for AuthorsThe authors have summarized the literature on targetted treatments for BTC. It is rather complete and update. It reads and flows well, is logical and written well.
My only comment is that I would have like to have seen a paragraph on the access to targeted treatments and NGS sequencing in the developed world. Access differs in the various Countries and with the strong data, this manuscript could be used as a call to action for countries that are not funding sequencing for patients, or access to drugs like pemigatinib for patients with mutations in BTC that are targetable.
Otherwise well done.
Author Response
"Please see the attachment."
Author Response File: Author Response.pdf
Reviewer 3 Report
Comments and Suggestions for AuthorsMar et al did a deep review of the current therapy strategies as well as latest NGS profiling and personalized therapy in biliary tract cancers (BTCs). The review focused on several target therapy mutations in BTCs, including IDH-1 mutations, FGFR2 fusions, HER2 overexpression/amplification, MSI/dMMR status, BRAF mutations, KRAS mutations, NTRK fusions, and RET fusions. The paper discussed the clinical significance of current personalized target therapy clinical trials based on the NSG mutation profile of BTCs, the paper emphasized the importance of integrating molecular profiling into clinical practice for optimized treatment selection and patient outcomes. The review paper was presented in a well-structured manner.
The review could discuss on the limitations of current molecular profiling and targeted therapies in BTCs, which could include challenges such as intratumor heterogeneity, intratumor drug response heterogeneity, treatment resistance, and the requirement for further research to optimize therapeutic strategies etc.
Author Response
"Please see the attachment."
Author Response File: Author Response.pdf
Round 2
Reviewer 1 Report
Comments and Suggestions for AuthorsThank you for addressing our comments.
