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Book ; Online: Fast Facts : Cholangiocarcinoma

Shroff, Rachna T.

Diagnostic and therapeutic advances are improving outcomes

2021

Abstract: Cholangiocarcinomas (CCAs) are a group of heterogeneous tumors that have traditionally had poor prognosis. Despite being rare, the global incidence of CCA has increased dramatically over the last few decades. However, alongside this, there have been ... ...

Title variant	Fast Facts
Author's details	Rachna T. Shroff, Chiara Braconi
Abstract	Cholangiocarcinomas (CCAs) are a group of heterogeneous tumors that have traditionally had poor prognosis. Despite being rare, the global incidence of CCA has increased dramatically over the last few decades. However, alongside this, there have been advancements in our understanding, diagnosis and treatment, improving the overall survival and quality of life of patients with advanced disease. This compact yet comprehensive review of CCA serves as a guide for physicians, oncologists, allied health professionals, scientists, patients and caregivers to update their knowledge of the most recent clinical developments and most promising areas of research. Table of Contents: • Pathophysiology, etiology and epidemiology • Diagnosis • Biliary drainage and supportive care • Surgical resection and transplantation • Translational research • Systemic therapy • Immunotherapy • Radiotherapy and photodynamic therapy
Keywords	Gastroenterology
Language	English
Size	1 online resource (48 pages) :, 6 figures, 3 in color, 9 tables
Publisher	S. Karger
Publishing place	Basel
Document type	Book ; Online
ISBN	3-318-06810-1 ; 978-3-318-06810-8
Database	ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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Article ; Online: Decision-Making Regarding Perioperative Therapy in Individuals with Localized Pancreatic Adenocarcinoma.

Savani, Malvi / Shroff, Rachna T

Hematology/oncology clinics of North America

2022 Volume 36, Issue 5, Page(s) 961–978

Abstract: Pancreatic cancer is a fatal malignancy that is projected to emerge as the second leading cause of cancer-related death in the United States. Despite the critical advances in surgical strategies, radiographic techniques, and systemic therapy, the ... ...

Abstract	Pancreatic cancer is a fatal malignancy that is projected to emerge as the second leading cause of cancer-related death in the United States. Despite the critical advances in surgical strategies, radiographic techniques, and systemic therapy, the treatment modality has remained largely unchanged over the past two decades eliciting a dire need for clinical trials in improving quality of life and prolonging survival in this patient population. Emergence of innovative strategies including novel combination chemotherapy, immunotherapy, vaccines, small compound drugs, among others is avenues under investigation to improve perioperative outcomes in localized pancreatic cancer.
MeSH term(s)	Humans ; Pancreatic Neoplasms/surgery ; Pancreatic Neoplasms/drug therapy ; Adenocarcinoma/surgery ; Adenocarcinoma/drug therapy ; Quality of Life ; Neoadjuvant Therapy ; Pancreatic Neoplasms
Language	English
Publishing date	2022-10-17
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	93115-9
ISSN	1558-1977 ; 0889-8588
ISSN (online)	1558-1977
ISSN	0889-8588
DOI	10.1016/j.hoc.2022.07.003
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Article: Biliary cancer: gateway to comprehensive molecular profiling.

Sardar, Muhammad / Shroff, Rachna T

Clinical advances in hematology & oncology : H&O

2021 Volume 19, Issue 1, Page(s) 27–34

Abstract: Cholangiocarcinoma is a rare malignancy with a poor prognosis. The majority of tumors present at an advanced stage, and relapse often occurs after surgery conducted with curative intent. In both of these cases, standard treatment is a combination of ... ...

Abstract	Cholangiocarcinoma is a rare malignancy with a poor prognosis. The majority of tumors present at an advanced stage, and relapse often occurs after surgery conducted with curative intent. In both of these cases, standard treatment is a combination of cisplatin and gemcitabine. The use of folinic acid, 5-fluorouracil, and oxaliplatin (FOLFOX) in second-line treatment improves survival, but outcomes remain dismal. Studies have shown that cholangiocarcinoma possesses a wide spectrum of genetic aberrations. Clinical trials evaluating targeted therapies in patients with FGFR2 fusions, IDH1 mutations, and BRAF mutations have yielded very promising results, and the agents were generally well tolerated. Several FGFR2 fusion-targeted agents have achieved response rates between 20.7% and 35.5%, with disease stability rates ranging between 76% and 82%. Agents targeting FGFR2 fusions also have produced median progression-free survival (PFS) ranging from 5.7 to 6.9 months and median overall survival (OS) ranging from 12.5 to 21.1 months. Ivosidenib in patients with an IDH1/2 mutation has produced a response rate of 2% and a disease stability rate of 51%, with median PFS of 2.7 months and median OS of 10.8 months. In patients with a BRAF mutation, a combination of dabrafenib and trametinib led to an overall response rate of 51% and disease stability in another 40% of patients. Median PFS and OS were 9 and 14 months, respectively. Patients should be encouraged to participate in clinical trials.
MeSH term(s)	Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Biliary Tract Neoplasms/drug therapy ; Biliary Tract Neoplasms/genetics ; Biliary Tract Neoplasms/metabolism ; Biliary Tract Neoplasms/mortality ; Cholangiocarcinoma/drug therapy ; Cholangiocarcinoma/genetics ; Cholangiocarcinoma/metabolism ; Cholangiocarcinoma/mortality ; Cisplatin/therapeutic use ; Deoxycytidine/analogs & derivatives ; Deoxycytidine/therapeutic use ; Disease-Free Survival ; Fluorouracil/therapeutic use ; Humans ; Leucovorin/therapeutic use ; Mutation ; Oncogene Proteins, Fusion/genetics ; Oncogene Proteins, Fusion/metabolism ; Organoplatinum Compounds/therapeutic use ; Survival Rate
Chemical Substances	Oncogene Proteins, Fusion ; Organoplatinum Compounds ; Deoxycytidine (0W860991D6) ; gemcitabine (B76N6SBZ8R) ; Cisplatin (Q20Q21Q62J) ; Leucovorin (Q573I9DVLP) ; Fluorouracil (U3P01618RT)
Language	English
Publishing date	2021-01-27
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2271951-9
ISSN	1543-0790
ISSN	1543-0790
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Article: Cholangiocarcinoma: a review of the literature and future directions in therapy.

Halder, Ritika / Amaraneni, Akshay / Shroff, Rachna T

Hepatobiliary surgery and nutrition

2022 Volume 11, Issue 4, Page(s) 555–566

Abstract: Cholangiocarcinomas (CCA) are a group of rare cancers with an incidence of about 1.26 per 100,000 people. The disease reflects one of three different subtypes: intrahepatic, perihilar or hilar and distal cholangiocarcinoma. The preferred modality of ... ...

Abstract	Cholangiocarcinomas (CCA) are a group of rare cancers with an incidence of about 1.26 per 100,000 people. The disease reflects one of three different subtypes: intrahepatic, perihilar or hilar and distal cholangiocarcinoma. The preferred modality of definitive therapy is surgical resection with or without adjuvant therapy, however the majority of patients with this disease do not present at an early stage. Some efforts to improve survival rates have come in the form of offering neoadjuvant therapy prior to surgical resection or liver transplantation. Some new protocols are in the process of development for neoadjuvant therapy. Despite advancements in locally advanced or borderline resectable lesions, most patient present at an advanced stage. The mainstay of treatment for advanced stage disease is chemotherapy regardless of location. The mainstay of treatment in fit patients is the combination of gemcitabine and cisplatin. The addition of nab-paclitaxel to this backbone is currently being evaluated in phase III trial. In addition, the role of targeted therapy is currently being studied extensively through multiple different mutational pathways including isocitrate dehydrogenase-1 (IDH1), fibroblast growth factor receptor (FGFR), epidermal growth factor receptor (EGFR) and ERBB2 (HER2/neu). CCA remains a significant challenge in medicine, however recent studies have shown that there is significant interest in advancing therapy in the form of neoadjuvant, adjuvant and palliative intent treatment.
Language	English
Publishing date	2022-08-04
Publishing country	China (Republic : 1949- )
Document type	Journal Article ; Review
ZDB-ID	2812398-0
ISSN	2304-389X ; 2304-3881
ISSN (online)	2304-389X
ISSN	2304-3881
DOI	10.21037/hbsn-20-396
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Article: Novel biomarkers and the future of targeted therapies in cholangiocarcinoma: a narrative review.

Munugala, Nishant / Maithel, Shishir K / Shroff, Rachna T

Hepatobiliary surgery and nutrition

2022 Volume 11, Issue 2, Page(s) 253–266

Abstract: Background and objectives: Cholangiocarcinoma is a highly aggressive and heterogenous group of biliary malignancies arising from any site in the biliary tree, comprising 15% of all primary liver cancers. The nature of the disease and nonspecific ... ...

Abstract	Background and objectives: Cholangiocarcinoma is a highly aggressive and heterogenous group of biliary malignancies arising from any site in the biliary tree, comprising 15% of all primary liver cancers. The nature of the disease and nonspecific presentation leads to late diagnosis and ultimately poor outcomes for patients. Combination gemcitabine and cisplatin has been the standard of care for cholangiocarcinoma (CCA) since 2010, with a median overall survival of 11.7 months. The five-year survival for CCA remains 5-10%, revealing a clear need for improved treatment options. Methods: This targeted review highlights the role of next generation sequencing in CCA and the clinically relevant tumor biomarkers that have become the focus of therapeutic development. Key content and findings: These tumor biomarkers or actionable mutations hold the potential to enable earlier diagnosis, provide prognostic information, and guide treatment decisions for patients with CCA. Specifically, the Conclusion: The discovery of these actionable mutations and identification of targeted therapies have challenged the notion of a "one-size fits all" for treatment of CCA, and generated optimism that these novel treatments will soon be available for patients with CCA.
Language	English
Publishing date	2022-09-04
Publishing country	China (Republic : 1949- )
Document type	Journal Article ; Review
ZDB-ID	2812398-0
ISSN	2304-389X ; 2304-3881
ISSN (online)	2304-389X
ISSN	2304-3881
DOI	10.21037/hbsn-20-475
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Article ; Online: Precision Medicine in Biliary Tract Cancer.

Scott, Aaron J / Sharman, Reya / Shroff, Rachna T

Journal of clinical oncology : official journal of the American Society of Clinical Oncology

2022 Volume 40, Issue 24, Page(s) 2716–2734

Abstract: Precision medicine has become a dominant theme in the treatment of biliary tract cancers (BTCs). Although prognosis remains poor, technologies for improved molecular characterization along with the US Food and Drug Administration approval of several ... ...

Abstract	Precision medicine has become a dominant theme in the treatment of biliary tract cancers (BTCs). Although prognosis remains poor, technologies for improved molecular characterization along with the US Food and Drug Administration approval of several targeted therapies have changed the therapeutic landscape of advanced BTC. The hallmark of BTC oncogenesis is chronic inflammation of the liver and biliary tract regardless of the anatomical subtype. Subtypes of BTC correspond to distinct molecular characteristics, making BTC a molecularly heterogenous collection of tumors. Collectively, up to 40% of BTCs harbor a potentially targetable molecular abnormality, and the National Comprehensive Cancer Network guidelines recommend molecular profiling for all patients with advanced BTC. Use of circulating tumor DNA, immunohistochemistry, and next-generation sequencing continues to expand the utility for biomarker-driven management and molecular monitoring of BTC. Improving outcomes using biomarker-agnostic treatment for nontargetable tumors also remains a priority, and combinational treatment strategies such as immune checkpoint inhibition plus chemotherapy hold promise for this subgroup of patients.
MeSH term(s)	Biliary Tract Neoplasms/drug therapy ; Biliary Tract Neoplasms/genetics ; High-Throughput Nucleotide Sequencing ; Humans ; Molecular Targeted Therapy ; Precision Medicine ; Prognosis
Language	English
Publishing date	2022-07-15
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	604914-x
ISSN	1527-7755 ; 0732-183X
ISSN (online)	1527-7755
ISSN	0732-183X
DOI	10.1200/JCO.21.02576
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Article ; Online: New Treatment Options for Advanced Biliary Tract Cancer.

Mizrahi, Jonathan D / Shroff, Rachna T

Current treatment options in oncology

2020 Volume 21, Issue 8, Page(s) 63

Abstract: Opinion statement: The standard of care first-line therapy for patients with advanced biliary tract cancers eligible for treatment continues to be the combination of gemcitabine and cisplatin. Based on the promising results of a phase II study, an ... ...

Abstract	Opinion statement: The standard of care first-line therapy for patients with advanced biliary tract cancers eligible for treatment continues to be the combination of gemcitabine and cisplatin. Based on the promising results of a phase II study, an ongoing multi-institutional phase III study is assessing the benefit of adding nab-paclitaxel to the chemotherapy doublet, and appropriate patients should be considered for enrollment at participating centers. We would recommend early comprehensive genomic profiling of patients' tumors to identify potentially targetable aberrations with available therapies. Results with therapeutic implications include tumors with microsatellite instability/deficient mismatch repair, alterations in FGFR, IDH1/2, and HER-2, and potentially other molecular vulnerabilities. Patients in whom a targetable genomic abnormality is found should be matched with appropriate agent. If a targetable fusion or mutation is not detected, patients eligible for second-line therapy should be considered for either clinical trial enrollment or a second-line cytotoxic chemotherapy regimen such as modified FOLFOX. Strategies incorporating immunotherapy into the treatment of patients with microsatellite stable advanced biliary tract cancers have yielded largely disappointing results thus far, and routine use of checkpoint inhibitors outside of a clinical trial is not recommended.
MeSH term(s)	Biliary Tract Neoplasms/diagnosis ; Biliary Tract Neoplasms/etiology ; Biliary Tract Neoplasms/therapy ; Biomarkers, Tumor ; Clinical Decision-Making ; Combined Modality Therapy ; Disease Management ; Disease Susceptibility ; Genetic Predisposition to Disease ; Humans ; Neoplasm Metastasis ; Neoplasm Staging ; Treatment Outcome
Chemical Substances	Biomarkers, Tumor
Language	English
Publishing date	2020-06-29
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2057351-0
ISSN	1534-6277 ; 1527-2729
ISSN (online)	1534-6277
ISSN	1527-2729
DOI	10.1007/s11864-020-00767-3
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Article ; Online: What is the role of PARP inhibitors in pancreatic cancer?

Halder, Ritika / Shroff, Rachna T

Expert review of anticancer therapy

2020 Volume 20, Issue 11, Page(s) 913–918

MeSH term(s)	Adenocarcinoma/drug therapy ; Adenocarcinoma/pathology ; Humans ; Molecular Targeted Therapy ; Pancreatic Neoplasms/drug therapy ; Pancreatic Neoplasms/pathology ; Poly(ADP-ribose) Polymerase Inhibitors/administration & dosage ; Poly(ADP-ribose) Polymerase Inhibitors/pharmacology ; Survival Rate
Chemical Substances	Poly(ADP-ribose) Polymerase Inhibitors
Language	English
Publishing date	2020-09-11
Publishing country	England
Document type	Editorial
ZDB-ID	2112544-2
ISSN	1744-8328 ; 1473-7140
ISSN (online)	1744-8328
ISSN	1473-7140
DOI	10.1080/14737140.2020.1816174
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Article ; Online: Charging forward in locally advanced pancreatic cancer.

Segar, Jennifer / Shroff, Rachna T

The lancet. Gastroenterology & hepatology

2020 Volume 5, Issue 3, Page(s) 234–236

MeSH term(s)	Albumins ; Deoxycytidine/analogs & derivatives ; Humans ; Paclitaxel ; Pancreatic Neoplasms
Chemical Substances	130-nm albumin-bound paclitaxel ; Albumins ; Deoxycytidine (0W860991D6) ; gemcitabine (B76N6SBZ8R) ; Paclitaxel (P88XT4IS4D)
Language	English
Publishing date	2020-01-14
Publishing country	Netherlands
Document type	Journal Article ; Comment
ISSN	2468-1253
ISSN (online)	2468-1253
DOI	10.1016/S2468-1253(19)30404-2
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Article ; Online: COVID-19 Vaccines and Immunosuppressed Patients With Cancer: Critical Considerations.

Cazeau, Naomi / Palazzo, Meighan / Savani, Malvi / Shroff, Rachna T

Clinical journal of oncology nursing

2022 Volume 26, Issue 4, Page(s) 367–373

Abstract: Background: Patients with cancer are highly vulnerable to COVID-19 because of immunosuppression from diseases and treatments. Emerging data characterize the impact of COVID-19 vaccines related to cancer malignancies and treatments.: Objectives: ... ...

Abstract	Background: Patients with cancer are highly vulnerable to COVID-19 because of immunosuppression from diseases and treatments. Emerging data characterize the impact of COVID-19 vaccines related to cancer malignancies and treatments. Objectives: This article provides a clinical foundation on the immune response to the COVID-19 vaccine associated with the impact of cancer and its related treatments. It reviews strategies for vaccine scheduling, Centers for Disease Control and Prevention recommendations, and nursing considerations when administering the vaccine to immunosuppressed patients. Methods: Research studies about immune responses to COVID-19 vaccines among immunosuppressed patients with hematologic and solid tumor malignancies were summarized. Findings: Studies about the humoral immune responses of patients with cancer to COVID-19 vaccines help guide vaccination planning for this population. Critical nursing considerations for patients with cancer receiving COVID-19 vaccination are integral to the provision of optimal clinical oncology care during the pandemic.
MeSH term(s)	COVID-19/prevention & control ; COVID-19 Vaccines ; Humans ; Immunocompromised Host ; Neoplasms/drug therapy ; Pandemics ; Vaccination
Chemical Substances	COVID-19 Vaccines
Language	English
Publishing date	2022-08-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	2014665-6
ISSN	1538-067X ; 1092-1095
ISSN (online)	1538-067X
ISSN	1092-1095
DOI	10.1188/22.CJON.367-373
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