Published online Aug 15, 2022. doi: 10.4251/wjgo.v14.i8.1446
Peer-review started: February 12, 2022
First decision: April 17, 2022
Revised: April 30, 2022
Accepted: July 6, 2022
Article in press: July 6, 2022
Published online: August 15, 2022
Processing time: 179 Days and 10.9 Hours
Bile duct tumors are comprised of tumors that originate from both intrahepatic and extrahepatic bile ducts and gallbladder tumors. These are aggressive tumors and chemotherapy is still the main treatment for advanced-stage disease and most of these cases have a poor overall survival. Strategies are aimed at treatments with better outcomes and less toxicity which makes immunotherapy an area of significant importance. Recent Food and Drug Administration approvals of immune checkpoint inhibitors (ICI) for agnostic tumors based on biomarkers such as microsatellite instability-high and tumor mutation burden-high are important steps in the treatment of patients with advanced bile duct tumors. Despite limited responses with isolated checkpoint inhibitors in later lines of systemic treatment in advanced disease, drug combination strategies have been demonstrating encouraging results to enhance ICI efficacy.
Core Tip: Chemotherapy remains the main treatment for advanced bile duct tumors regardless of tumor aggressiveness and poor overall survival rates. The Food and Drug Administration has approved immune checkpoint inhibitors for agnostic tumors based on biomarkers such as microsatellite instability-high and tumor mutation burden-high. They are important steps in combined treatment with systemic chemotherapy for patients with advanced disease and show encouraging results.