Review
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Oct 27, 2020; 12(10): 693-708
Published online Oct 27, 2020. doi: 10.4254/wjh.v12.i10.693
Neoadjuvant treatment strategies for intrahepatic cholangiocarcinoma
Clifford Akateh, Aslam M Ejaz, Timothy Michael Pawlik, Jordan M Cloyd
Clifford Akateh, Timothy Michael Pawlik, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States
Aslam M Ejaz, Jordan M Cloyd, Department of Surgery, The Ohio State University, Columbus, OH 43210, United States
Author contributions: Akateh C contributed to the study design, manuscript writing and critical revision; Ejaz A contributed to the manuscript writing and critical revision; Pawlik TM contributed to the manuscript writing and critical revision; Cloyd JM contributed to the study design, manuscript writing and critical revision.
Conflict-of-interest statement: The authors have no conflicts of interest to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Jordan M Cloyd, MD, Assistant Professor, Department of Surgery, The Ohio State University, 410 W 10th Ave, N-907, Columbus, OH 43210, United States. jordan.cloyd@osumc.edu
Received: August 3, 2020
Peer-review started: August 3, 2020
First decision: August 9, 2020
Revised: August 21, 2020
Accepted: September 8, 2020
Article in press: September 8, 2020
Published online: October 27, 2020
Core Tip

Core Tip: Liver resection is the primary component of curative-intent treatment for patients with localized intrahepatic cholangiocarcinoma (ICC). However, a majority of patients present with locally advanced disease and even those who undergo resection are at high risk of recurrence. Neoadjuvant therapy may successfully downstage a subset of patients to resectable disease and improve the long-term outcomes of patients treated with multimodality therapy. As such, the benefits of neoadjuvant treatment strategies aimed at down-staging the tumor and increasing resection rates are of great interest. While high-level evidence regarding the efficacy of neoadjuvant therapy in ICC is lacking, emerging evidence from case control series, as well as recent advances in systemic therapies, liver-directed treatments, and targeted therapies based on an improved understanding of cholangiocarcinogenesis have led to increasing interest in its use.