Biliary tract cancer (BTC) is a heterogeneous group of aggressive malignancies that arise from the epithelium of the biliary tract. Most patients present with locally advanced or metastatic disease at the time of diagnosis. For patients with unresectable BTC, the survival advantage provided by systemic chemotherapy was limited. Over the last decade, immunotherapy has significantly improved the therapeutic landscape of solid tumors. There is an increasing number of studies evaluating the application of immunotherapy in BTC, including immune checkpoint inhibitors (ICIs), cancer vaccines and adoptive cell therapy. The limited response to ICIs monotherapy in unselected patients prompted investigators to explore different combination therapy strategies. Early clinical trials of therapeutic cancer vaccination and adoptive cell therapy have shown encouraging clinical results. However, there still has been a long way to go via validation of therapeutic efficacy and exploration of strategies to increase the efficacy. Identifying biomarkers that predict the response to immunotherapy will allow a more accurate selection of candidates. This review will provide an up-to-date overview of the current clinical data on the role of immunotherapy, summarize the promising biomarkers predictive of the response to ICIs and discuss the perspective for future research direction of immunotherapy in advanced BTC.
Keyphrases
- cell therapy
- papillary thyroid
- locally advanced
- end stage renal disease
- combination therapy
- squamous cell
- clinical trial
- squamous cell carcinoma
- stem cells
- mesenchymal stem cells
- chronic kidney disease
- ejection fraction
- newly diagnosed
- rectal cancer
- prognostic factors
- peritoneal dialysis
- open label
- randomized controlled trial
- radiation therapy
- electronic health record
- childhood cancer
- lymph node
- patient reported
- deep learning
- machine learning
- phase ii study
- study protocol
- liver metastases