The Lynx Group
Cholangiocarcinoma News

Cholangiocarcinoma

December 2020, Vol 1, No 3 — January 5, 2021
At the 2020 Cholangiocarcinoma Summit, Nabeel El-Bardeesy, PhD, Associate Professor, Medicine, Harvard Medical School, and Associate Geneticist, Center for Cancer Research, Massachusetts General Hospital Cancer Center, Boston, MA, moderated a session titled “Molecular Biomarkers in CCA: Focus on Current and Emerging Technologies.” The session focused on how best to integrate the array of genomic testing platforms into clinical practice. The session included 2 presenters who discussed this topic.
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December 2020, Vol 1, No 3 — January 5, 2021
At diagnosis, the majority of patients with intrahepatic cholangiocarcinoma (CCA) present with advanced disease and a poor prognosis. Comprehensive genomic profiling (CGP) of intrahepatic CCA has revealed multiple potential therapeutic targets, including FGFR2, ERBB2 (HER2), and IDH1. Therefore, performing CGP early in the disease course is critical to increasing first-line clinical trial enrollment and access to treatment with FGFR inhibitors.
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The first confirmed case in the United States of the 2019 novel coronavirus (COVID-19) was reported on January 21, 2020, and as of November 27, 2020, there were >63 million confirmed cases and >1.5 million deaths globally. Despite the global impact, certain populations have been identified as having a higher risk of developing severe COVID-19 infection, including patients with cancer. Various studies have shown that patients with cancer experience particularly poor outcomes after COVID-19 infection. As a result of the pandemic, care delivery has been disrupted to some degree based on the need for prioritization and limitations on resources. Therefore, healthcare providers and patients have been continually reassessing the balance between the benefits and risks of anticancer interventions in the context of the added risk of COVID-19 infection.
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As a result of the COVID-19 pandemic, year 2020 has witnessed unprecedented changes in the practice of medicine. The effect on medical conferences has been equally dramatic, and several major meetings have been canceled or altered. Fortunately, the oncology community adapted quickly!
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The multidrug combination of toripalimab, lenvatinib plus chemotherapy with gemcitabine and oxaliplatin showed promising efficacy and tolerability in patients with intrahepatic CCA.
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Retrospective chart review data indicate that intrahepatic CCA and extrahepatic CCA exhibit disparate clinical features and molecular profile, and divergent treatment patterns.
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Real-world data indicate that genetic testing and personalized medicine is rarely applied in the community setting for patients with hepatobiliary and pancreatic cancers.
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Emerging data suggest that patient-derived 3-dimensional organoid model of intrahepatic CCA may allow personalized drug screening for active single agents or drug combinations similar to patient-derived xenograft models.
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Patient-derived tumor organoids may have clinical application to predict drug responses in a personalized treatment setting; they have shown concordance with actionable genomic anchors and retrospective treatment outcomes.
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Preclinical evidence presented at the AACR meeting implicates PKN2 signaling in resistance mechanisms in patients with FGFR2 fusion–positive intrahepatic CCA.
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