CCA Summit 2020 Highlights

A periadjuvant, or perioperative, approach to the treatment of biliary tract cancers, including cholangiocarcinoma (CCA), has several potential advantages that may offer an opportunity to improve outcomes in these diseases, said James Harding, MD, Regional Director, Early Drug Development, Memorial Sloan Kettering Cancer Center, New York, NY, at the 2020 Annual Cholangiocarcinoma Summit.

Flavio Rocha, MD, Hepatopancreatobiliary Surgeon, Virginia Mason Medical Center, Director of Research, Digestive Disease Institute, and Associate Medical Director of the Floyd and Delores Jones Cancer Institute, Seattle, WA, provided an overview of the changes made in the 8th edition of the AJCC’s tumor, node, metastasis (TNM) staging system at the 2020 Annual Cholangiocarcinoma Summit. These changes have direct implications for the management of patients with hilar or intrahepatic CCA.

The recent FDA approval of the first FGFR inhibitor, pemigatinib (Pemazyre), and the positive results from the phase 3 study of the first IDH1 inhibitor, ivosidenib (Tibsovo), represent major breakthroughs in the treatment of patients with cholangiocarcinoma (CCA), a rare cancer associated with poor outcomes. However, the duration of response with these agents is still relatively short.

The current standard of care for the systemic treatment of patients with advanced gallbladder cancer is the chemotherapy combination of gemcitabine and cisplatin, which is suboptimal, yielding only modest benefit, said Richard Kim, MD, Section Chief, Gastrointestinal Medical Oncology, Moffitt Cancer Center, Tampa, FL, at the 2020 Cholangiocarcinoma Summit.

In April 2020, the FDA granted accelerated approval to pemigatinib (Pemazyre), the first targeted therapy for cholangiocarcinoma (CCA). The FGFR inhibitor was approved for adults with CCA and FGFR2 fusion.

Targeted therapy has improved survival for patients with cancer across a broad spectrum of disease sites, but until recently, progress has been slow in the treatment of patients with cholangiocarcinoma (CCA).

New cytotoxic chemotherapy regimens and novel combinations are being evaluated in clinical trials in an effort to improve the outcomes of chemotherapy in the adjuvant and palliative settings in patients with biliary tract cancer, including cholangiocarcinoma (CCA), said Angela Lamarca, MD, PhD, MSc, Consultant, Medical Oncology, the Christie NHS Foundation Trust, Manchester, United Kingdom. She discussed the future of cytotoxic chemotherapy for this patient population at the 2020 Cholangiocarcinoma Summit.

Liver transplant is emerging as a treatment option in patients with unresectable hilar or intrahepatic cholangiocarcinoma (CCA), with accumulating data supporting transplant protocols in patients with early-stage CCA.

Despite the onslaught of the COVID-19 pandemic, researchers are hard at work to develop innovative therapies that will make a difference in the lives of patients with cancer.