Published online Mar 27, 2024. doi: 10.4240/wjgs.v16.i3.635
Peer-review started: November 16, 2023
First decision: December 17, 2023
Revised: December 26, 2023
Accepted: February 18, 2024
Article in press: February 18, 2024
Published online: March 27, 2024
Processing time: 127 Days and 5.6 Hours
This editorial contains comments on the article “Systematic sequential therapy for ex vivo liver resection and autotransplantation: A case report and review of li
Core Tip: Perihilar cholangiocarcinoma is still hard to treat due to late diagnosis and extremely complicated surgical options. Ex vivo liver resection and autotransplantation brings some hope, but it could be performed only in carefully selected patients. Advanced disease requires systemic anticancer treatment, which is supposed to be individualized according to the genetic and molecular features of cancer cells. Targeted therapy in combination with chemo-immunotherapy could be effective in susceptible patients.
- Citation: Tchilikidi KY. Ex vivo liver resection and auto-transplantation and special systemic therapy in perihilar cholangiocarcinoma treatment. World J Gastrointest Surg 2024; 16(3): 635-640
- URL: https://www.wjgnet.com/1948-9366/full/v16/i3/635.htm
- DOI: https://dx.doi.org/10.4240/wjgs.v16.i3.635
Cholangiocarcinoma (CCA) is the main malignancy in the biliary tract. It is classified into three subtypes according to localization. Intrahepatic CCA is the second primary liver cancer after hepatocellular carcinoma (HCC). Perihilar CCA (pCCA) or Klatskin’ tumor originates from left, right, and common hepatic ducts distal to second order biliary branches and proximal to the cystic duct confluence. Distal CCA arises from the common bile duct proximal to the Vater’s ampula. In fact, CCA is a heterogeneous group of malignancies with different genetic and molecular features[1-4]. Those genetic and molecular properties make this malignancy chemo-radio-resistant, shrinking the number of available therapeutic options.
The only curative option is radical surgery. However, the location of pCCA leads to late diagnosis of the disease fre
Results of allogeneic liver transplantation (LT) in CCA did not bring this procedure to routine use like in HCC. As stated by Sapisochín et al[5], as well as other authors, pCCA could be an accepted indication for orthotopic LT in some centers under a strict selection process and after neoadjuvant chemoradiation. Intrahepatic CCA is a formal contraindication for LT in most centers worldwide due to the poor reported results, despite that neoadjuvant chemoradiation makes them better[5-7].
On the other hand, ex vivo liver resection auto-transplantation (ELRAT), since first introduced by Pichlmayr et al[8] in 1988, has taken its place among surgical options for non-malignant lesions and malignancies including carefully selected pCCA patients[8,9].
Systemic anticancer therapy in pCCA has common limitations as in other CCA locations. Just a few chemotherapy regimens showed certain efficacy. Due to recent advances in genetic and molecular mapping, targeted agents have started to become treatment options for selected CCA patients. They open new possibilities in advanced stage CCA. Despite everything, CCA is still a highly lethal disease that requires complicated surgical excision and is resistant to systemic therapy. That is why every successful treatment should be taken into account. One of them is the case report by Hu et al[10] “Systematic sequential therapy for ex vivo liver resection and autotransplantation: A case report and review of li
Hardy et al[11,12] in 1963 first reported extracorporeal procedures with organs followed by kidney re-implantation after high ureteral injury. Newly introduced in the 1980s, reduced-size, split and auxiliary LT were techniques that precluded ex situ liver resections[13-15]. Publications about ELRAT started with Pichlmayr et al[8] in 1988[8]. ELRAT allows avoid
Results in cancer patients are still controversial with higher morbidity and mortality that do not make ELRAT become a procedure widely used in these settings[2]. According to Zawistowski et al[20], among 244 patients involved in 53 studies, the 30-d mortality did not differ among patients with the nonmalignant and malignant diseases (11.3% vs 6.3%, P = 0.181). The 90-d mortality was higher for malignant tumors (21.6% vs 8.2%, P = 0.004), as well as in-hospital mortality (18.3% vs 2.7%, P < 0.001). The postoperative 1-year survival was worse in the malignant group (65.0% vs 89.7%, P < 0.001). Major postoperative complications took place less commonly in the nonmalignant group (21.0% vs 50.0%, P < 0.001). Post-hepatectomy liver failure occurred more frequently among patients with malignant tumors (23.0% vs 8.9%, P = 0.006; Table 1)[20].
Issue | Non-malignant diseases | Malignant tumors | P value |
30-d mortality | 6.3 | 11.3 | 0.181 |
90-d mortality | 8.2 | 12.5 | 0.004 |
In-hospital mortality | 2.7 | 18.3 | < 0.001 |
1-year survival | 89.7 | 65.0 | < 0.001 |
Major postoperative complications | 21.0 | 50.0 | < 0.001 |
Post-hepatectomy liver failure | 8.9 | 23.0 | 0.006 |
Nevertheless, several publications on ELRAT in malignancies including pCCA appeared in last years. That allows Kato et al[21] in 2020 and Weiner et al[22] in 2022 as well as other authors to make conclusion about this method as an al
Due to the lack of specific clinical presentations in early stages, most of biliary tract carcinomas are diagnosed as ad
Rapid development of cancer genetic mapping and molecular mechanism discovery in the last decade has changed tar
Immunotherapy becomes a game changer in some malignancies such as melanoma, but unfortunately not in CCA. Results of programmed death protein ligand 1 (PD-L1) inhibitors pembrolizumab and nivolumab were mixed[29,35-37]. Programmed death protein 1 (PD-1)/PD-L1 inhibitors can be used in high microsatellite instable (MSI-H) tumors. MSI-H as a result of DNA mismatch repair defects (dMMR) could appear in different malignancies. MSI-H is rare in intrahepatic CCA, but more frequent in extrahepatic CCA[38]. The phase III TOPAZ-1 trial presented promising results for the PD-L1 inhibitor durvalumab in combination with gemcitabine/cisplatin, mostly confirmed by Rimini et al[39] and Macias et al[40]. Macias et al[40] in their recent editorial article called the above regimen “new first-line standard of care for patients with advanced biliary tract cancer after more than 10 years of chemotherapy alone”[40,41]. The FDA recommended pem
Lenvatinib, as a multi-kinase inhibitor of VEGF receptors 1–3, FGF receptors 1–4, platelet derived growth factor re
Infigratinib is a reversible ATP-competitive FGFR 1–3 inhibitor. It is actively investigating now. Yu et al[46] concluded that tumor resistance to reversible FGFR inhibitors including infigratinib could be a barrier for the clinical benefits of infigratinib in CCA. They also proposed perspectives with its future administration in combination with immunotherapy[46].
Anticancer therapy in the article of Hu et al[10] included conditionally approved agents. So again, further surveillance is necessary.
pCCA is still hard to treat due to late diagnosis and extremely complicated surgical options. ELRAT also brings some hope, but it could be performed only in carefully selected patients. Advanced disease requires systemic anticancer treat
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Specialty type: Gastroenterology and hepatology
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1. | Banales JM, Marin JJG, Lamarca A, Rodrigues PM, Khan SA, Roberts LR, Cardinale V, Carpino G, Andersen JB, Braconi C, Calvisi DF, Perugorria MJ, Fabris L, Boulter L, Macias RIR, Gaudio E, Alvaro D, Gradilone SA, Strazzabosco M, Marzioni M, Coulouarn C, Fouassier L, Raggi C, Invernizzi P, Mertens JC, Moncsek A, Rizvi S, Heimbach J, Koerkamp BG, Bruix J, Forner A, Bridgewater J, Valle JW, Gores GJ. Cholangiocarcinoma 2020: the next horizon in mechanisms and management. Nat Rev Gastroenterol Hepatol. 2020;17:557-588. [PubMed] [DOI] [Cited in This Article: ] [Cited by in Crossref: 1188] [Cited by in RCA: 1327] [Article Influence: 265.4] [Reference Citation Analysis (0)] |
2. | Brindley PJ, Bachini M, Ilyas SI, Khan SA, Loukas A, Sirica AE, Teh BT, Wongkham S, Gores GJ. Cholangiocarcinoma. Nat Rev Dis Primers. 2021;7:65. [PubMed] [DOI] [Cited in This Article: ] [Cited by in Crossref: 100] [Cited by in RCA: 383] [Article Influence: 95.8] [Reference Citation Analysis (0)] |
3. | Moris D, Palta M, Kim C, Allen PJ, Morse MA, Lidsky ME. Advances in the treatment of intrahepatic cholangiocarcinoma: An overview of the current and future therapeutic landscape for clinicians. CA Cancer J Clin. 2023;73:198-222. [PubMed] [DOI] [Cited in This Article: ] [Cited by in Crossref: 4] [Cited by in RCA: 173] [Article Influence: 86.5] [Reference Citation Analysis (0)] |
4. | DeOliveira ML, Cunningham SC, Cameron JL, Kamangar F, Winter JM, Lillemoe KD, Choti MA, Yeo CJ, Schulick RD. Cholangiocarcinoma: thirty-one-year experience with 564 patients at a single institution. Ann Surg. 2007;245:755-762. [PubMed] [DOI] [Cited in This Article: ] [Cited by in Crossref: 882] [Cited by in RCA: 986] [Article Influence: 54.8] [Reference Citation Analysis (1)] |
5. | Sapisochín G, Fernández de Sevilla E, Echeverri J, Charco R. Liver transplantation for cholangiocarcinoma: Current status and new insights. World J Hepatol. 2015;7:2396-2403. [PubMed] [DOI] [Cited in This Article: ] [Cited by in Crossref: 34] [Cited by in RCA: 40] [Article Influence: 4.0] [Reference Citation Analysis (0)] |
6. | Safarpour AR, Askari H, Ejtehadi F, Azarnezhad A, Raeis-Abdollahi E, Tajbakhsh A, Abazari MF, Tarkesh F, Shamsaeefar A, Niknam R, Sivandzadeh GR, Lankarani KB. Cholangiocarcinoma and liver transplantation: What we know so far? World J Gastrointest Pathophysiol. 2021;12:84-105. [PubMed] [DOI] [Cited in This Article: ] [Cited by in CrossRef: 1] [Cited by in RCA: 3] [Article Influence: 0.8] [Reference Citation Analysis (1)] |
7. | Giovinazzo F, Pascale MM, Cardella F, Picarelli M, Molica S, Zotta F, Martullo A, Clarke G, Frongillo F, Grieco A, Agnes S. Current Perspectives in Liver Transplantation for Perihilar Cholangiocarcinoma. Curr Oncol. 2023;30:2942-2953. [PubMed] [DOI] [Cited in This Article: ] [Reference Citation Analysis (0)] |
8. | Pichlmayr R, Bretschneider HJ, Kirchner E, Ringe B, Lamesch P, Gubernatis G, Hauss J, Niehaus KJ, Kaukemüller J. [Ex situ operation on the liver. A new possibility in liver surgery]. Langenbecks Arch Chir. 1988;373:122-126. [PubMed] [DOI] [Cited in This Article: ] [Cited by in Crossref: 99] [Cited by in RCA: 97] [Article Influence: 2.6] [Reference Citation Analysis (0)] |
9. | Yang X, Lu L, Zhu WW, Tao YF, Shen CH, Chen JH, Wang ZX, Qin LX. Ex vivo liver resection and auto-transplantation as an alternative to treat liver malignancies: Progress and challenges. Hepatobiliary Pancreat Dis Int. 2024;23:117-122. [DOI] [Cited in This Article: ] [Cited by in Crossref: 2] [Cited by in RCA: 1] [Article Influence: 0.5] [Reference Citation Analysis (0)] |
10. | Hu CL, Han X, Gao ZZ, Zhou B, Tang JL, Pei XR, Lu JN, Xu Q, Shen XP, Yan S, Ding Y. Systematic sequential therapy for ex vivo liver resection and autotransplantation: A case report and review of literature. World J Gastrointest Surg. 2023;15:2663-2673. [PubMed] [DOI] [Cited in This Article: ] [Reference Citation Analysis (0)] |
11. | HARDY JD. High ureteral injuries. Management by autotransplantation of the kidney. JAMA. 1963;184:97-101. [PubMed] [DOI] [Cited in This Article: ] [Cited by in Crossref: 153] [Cited by in RCA: 156] [Article Influence: 2.5] [Reference Citation Analysis (0)] |
12. | HARDY JD, ERASLAN S. AUTOTRANSPLANTATION OF THE KIDNEY FOR HIGH URETERAL INJURY. J Urol. 1963;90:563-574. [PubMed] [DOI] [Cited in This Article: ] [Cited by in Crossref: 27] [Cited by in RCA: 28] [Article Influence: 0.5] [Reference Citation Analysis (0)] |
13. | Broelsch CE, Emond JC, Thistlethwaite JR, Whitington PF, Zucker AR, Baker AL, Aran PF, Rouch DA, Lichtor JL. Liver transplantation, including the concept of reduced-size liver transplants in children. Ann Surg. 1988;208:410-420. [PubMed] [DOI] [Cited in This Article: ] [Cited by in Crossref: 142] [Cited by in RCA: 116] [Article Influence: 3.1] [Reference Citation Analysis (0)] |
14. | Emond JC, Whitington PF, Thistlethwaite JR, Alonso EM, Broelsch CE. Reduced-size orthotopic liver transplantation: use in the management of children with chronic liver disease. Hepatology. 1989;10:867-872. [PubMed] [DOI] [Cited in This Article: ] [Cited by in Crossref: 101] [Cited by in RCA: 101] [Article Influence: 2.8] [Reference Citation Analysis (0)] |
15. | Pichlmayr R, Ringe B, Gubernatis G, Hauss J, Bunzendahl H. [Transplantation of a donor liver to 2 recipients (splitting transplantation)--a new method in the further development of segmental liver transplantation]. Langenbecks Arch Chir. 1988;373:127-130. [PubMed] [DOI] [Cited in This Article: ] [Cited by in Crossref: 413] [Cited by in RCA: 412] [Article Influence: 11.1] [Reference Citation Analysis (0)] |
16. | Xu S, Hu C, Jiang Z, Li G, Zhou B, Gao Z, Yan S. In vivo total or partial hepatectomy followed by ex vivo liver resection and autotransplantation for malignant tumors: a single center experience. Front Oncol. 2023;13:1214451. [PubMed] [DOI] [Cited in This Article: ] [Reference Citation Analysis (0)] |
17. | Aji T, Dong JH, Shao YM, Zhao JM, Li T, Tuxun T, Shalayiadang P, Ran B, Jiang TM, Zhang RQ, He YB, Huang JF, Wen H. Ex vivo liver resection and autotransplantation as alternative to allotransplantation for end-stage hepatic alveolar echinococcosis. J Hepatol. 2018;69:1037-1046. [PubMed] [DOI] [Cited in This Article: ] [Cited by in Crossref: 59] [Cited by in RCA: 57] [Article Influence: 8.1] [Reference Citation Analysis (0)] |
18. | Qiu Y, Huang B, Yang X, Wang T, Shen S, Yang Y, Wang W. Evaluating the Benefits and Risks of Ex Vivo Liver Resection and Autotransplantation in Treating Hepatic End-stage Alveolar Echinococcosis. Clin Infect Dis. 2022;75:1289-1296. [PubMed] [DOI] [Cited in This Article: ] [Cited by in Crossref: 1] [Cited by in RCA: 1] [Article Influence: 0.3] [Reference Citation Analysis (0)] |
19. | Beldi G, Vuitton D, Lachenmayer A, Heyd B, Dufour JF, Richou C, Candinas D, Bresson-Hadni S. Is ex vivo liver resection and autotransplantation a valid alternative treatment for end-stage hepatic alveolar echinococcosis in Europe? J Hepatol. 2019;70:1030-1031. [PubMed] [DOI] [Cited in This Article: ] [Cited by in Crossref: 19] [Cited by in RCA: 17] [Article Influence: 2.8] [Reference Citation Analysis (0)] |
20. | Zawistowski M, Nowaczyk J, Jakubczyk M, Domagała P. Outcomes of ex vivo liver resection and autotransplantation: A systematic review and meta-analysis. Surgery. 2020;168:631-642. [PubMed] [DOI] [Cited in This Article: ] [Cited by in Crossref: 16] [Cited by in RCA: 11] [Article Influence: 2.2] [Reference Citation Analysis (0)] |
21. | Kato T, Hwang R, Liou P, Weiner J, Griesemer A, Samstein B, Halazun K, Mathur A, Schwartz G, Cherqui D, Emond J. Ex Vivo Resection and Autotransplantation for Conventionally Unresectable Tumors - An 11-year Single Center Experience. Ann Surg. 2020;272:766-772. [PubMed] [DOI] [Cited in This Article: ] [Cited by in Crossref: 6] [Cited by in RCA: 8] [Article Influence: 1.6] [Reference Citation Analysis (0)] |
22. | Weiner J, Hemming A, Levi D, Beduschi T, Matsumoto R, Mathur A, Liou P, Griesemer A, Samstein B, Cherqui D, Emond J, Kato T. Ex Vivo Liver Resection and Autotransplantation: Should It be Used More Frequently? Ann Surg. 2022;276:854-859. [PubMed] [DOI] [Cited in This Article: ] [Reference Citation Analysis (0)] |
23. | George A, Rammohan A, Reddy SM, Rela M. Ex situ liver resection and autotransplantation for advanced cholangiocarcinoma. BMJ Case Rep. 2019;12. [PubMed] [DOI] [Cited in This Article: ] [Cited by in Crossref: 6] [Cited by in RCA: 5] [Article Influence: 0.8] [Reference Citation Analysis (0)] |
24. | Valle JW, Kelley RK, Nervi B, Oh DY, Zhu AX. Biliary tract cancer. Lancet. 2021;397:428-444. [PubMed] [DOI] [Cited in This Article: ] [Cited by in Crossref: 227] [Cited by in RCA: 510] [Article Influence: 127.5] [Reference Citation Analysis (1)] |
25. | Hassan H, Chakrabarti S, Zemla T, Yin J, Wookey V, Prasai K, Abdellatief A, Katta R, Tran N, Jin Z, Cleary S, Roberts L, Mahipal A. Impact of perioperative chemotherapy on survival in patients with cholangiocarcinoma undergoing curative resection. Eur J Surg Oncol. 2023;49:106994. [PubMed] [DOI] [Cited in This Article: ] [Cited by in Crossref: 2] [Reference Citation Analysis (0)] |
26. | Parente A, Kamarajah SK, Baia M, Tirotta F, Manzia TM, Hilal MA, Pawlik TM, White SA, Dahdaleh FS. Neoadjuvant Chemotherapy for Intrahepatic, Perihilar, and Distal Cholangiocarcinoma: a National Population-Based Comparative Cohort Study. J Gastrointest Surg. 2023;27:741-749. [PubMed] [DOI] [Cited in This Article: ] [Cited by in Crossref: 5] [Cited by in RCA: 7] [Article Influence: 3.5] [Reference Citation Analysis (0)] |
27. | Valle J, Wasan H, Palmer DH, Cunningham D, Anthoney A, Maraveyas A, Madhusudan S, Iveson T, Hughes S, Pereira SP, Roughton M, Bridgewater J; ABC-02 Trial Investigators. Cisplatin plus gemcitabine vs gemcitabine for biliary tract cancer. N Engl J Med. 2010;362:1273-1281. [PubMed] [DOI] [Cited in This Article: ] [Cited by in Crossref: 2617] [Cited by in RCA: 3011] [Article Influence: 200.7] [Reference Citation Analysis (1)] |
28. | Möhring C, Feder J, Mohr RU, Sadeghlar F, Bartels A, Mahn R, Zhou T, Marinova M, Feldmann G, Brossart P, von Websky M, Matthaei H, Manekeller S, Glowka T, Kalff JC, Weismüller TJ, Strassburg CP, Gonzalez-Carmona MA. First Line and Second Line Chemotherapy in Advanced Cholangiocarcinoma and Impact of Dose Reduction of Chemotherapy: A Retrospective Analysis. Front Oncol. 2021;11:717397. [PubMed] [DOI] [Cited in This Article: ] [Cited by in Crossref: 8] [Cited by in RCA: 6] [Article Influence: 1.5] [Reference Citation Analysis (0)] |
29. | Munugala N, Maithel SK, Shroff RT. Novel biomarkers and the future of targeted therapies in cholangiocarcinoma: a narrative review. Hepatobiliary Surg Nutr. 2022;11:253-266. [PubMed] [DOI] [Cited in This Article: ] [Cited by in Crossref: 3] [Cited by in RCA: 14] [Article Influence: 4.7] [Reference Citation Analysis (0)] |
30. | Goyal L, Kongpetch S, Crolley VE, Bridgewater J. Targeting FGFR inhibition in cholangiocarcinoma. Cancer Treat Rev. 2021;95:102170. [PubMed] [DOI] [Cited in This Article: ] [Cited by in Crossref: 33] [Cited by in RCA: 36] [Article Influence: 9.0] [Reference Citation Analysis (0)] |
31. | Nakamura H, Arai Y, Totoki Y, Shirota T, Elzawahry A, Kato M, Hama N, Hosoda F, Urushidate T, Ohashi S, Hiraoka N, Ojima H, Shimada K, Okusaka T, Kosuge T, Miyagawa S, Shibata T. Genomic spectra of biliary tract cancer. Nat Genet. 2015;47:1003-1010. [PubMed] [DOI] [Cited in This Article: ] [Cited by in Crossref: 651] [Cited by in RCA: 887] [Article Influence: 88.7] [Reference Citation Analysis (0)] |
32. | Jain A, Javle M. Molecular profiling of biliary tract cancer: a target rich disease. J Gastrointest Oncol. 2016;7:797-803. [PubMed] [DOI] [Cited in This Article: ] [Cited by in Crossref: 44] [Cited by in RCA: 82] [Article Influence: 9.1] [Reference Citation Analysis (0)] |
33. | Yamashita-Kashima Y, Yoshimura Y, Fujimura T, Shu S, Yanagisawa M, Yorozu K, Furugaki K, Higuchi R, Shoda J, Harada N. Molecular targeting of HER2-overexpressing biliary tract cancer cells with trastuzumab emtansine, an antibody-cytotoxic drug conjugate. Cancer Chemother Pharmacol. 2019;83:659-671. [PubMed] [DOI] [Cited in This Article: ] [Cited by in Crossref: 11] [Cited by in RCA: 11] [Article Influence: 1.8] [Reference Citation Analysis (0)] |
34. | Kuwatani M, Sakamoto N. Promising Highly Targeted Therapies for Cholangiocarcinoma: A Review and Future Perspectives. Cancers (Basel). 2023;15. [PubMed] [DOI] [Cited in This Article: ] [Cited by in RCA: 4] [Reference Citation Analysis (0)] |
35. | Kang J, Jeong JH, Hwang HS, Lee SS, Park DH, Oh DW, Song TJ, Kim KH, Hwang S, Hwang DW, Kim SC, Park JH, Hong SM, Kim KP, Ryoo BY, Yoo C. Efficacy and Safety of Pembrolizumab in Patients with Refractory Advanced Biliary Tract Cancer: Tumor Proportion Score as a Potential Biomarker for Response. Cancer Res Treat. 2020;52:594-603. [PubMed] [DOI] [Cited in This Article: ] [Cited by in Crossref: 34] [Cited by in RCA: 38] [Article Influence: 6.3] [Reference Citation Analysis (0)] |
36. | Kim RD, Chung V, Alese OB, El-Rayes BF, Li D, Al-Toubah TE, Schell MJ, Zhou JM, Mahipal A, Kim BH, Kim DW. A Phase 2 Multi-institutional Study of Nivolumab for Patients With Advanced Refractory Biliary Tract Cancer. JAMA Oncol. 2020;6:888-894. [PubMed] [DOI] [Cited in This Article: ] [Cited by in Crossref: 162] [Cited by in RCA: 302] [Article Influence: 75.5] [Reference Citation Analysis (0)] |
37. | Wang M, Chen Z, Guo P, Wang Y, Chen G. Therapy for advanced cholangiocarcinoma: Current knowledge and future potential. J Cell Mol Med. 2021;25:618-628. [PubMed] [DOI] [Cited in This Article: ] [Cited by in Crossref: 6] [Cited by in RCA: 23] [Article Influence: 4.6] [Reference Citation Analysis (0)] |
38. | Winkelmann R, Schneider M, Hartmann S, Schnitzbauer AA, Zeuzem S, Peveling-Oberhag J, Hansmann ML, Walter D. Microsatellite Instability Occurs Rarely in Patients with Cholangiocarcinoma: A Retrospective Study from a German Tertiary Care Hospital. Int J Mol Sci. 2018;19. [PubMed] [DOI] [Cited in This Article: ] [Cited by in Crossref: 26] [Cited by in RCA: 31] [Article Influence: 4.4] [Reference Citation Analysis (0)] |
39. | Rimini M, Fornaro L, Lonardi S, Niger M, Lavacchi D, Pressiani T, Lucchetti J, Giordano G, Pretta A, Tamburini E, Pirrone C, Rapposelli IG, Diana A, Martinelli E, Garajová I, Simionato F, Schirripa M, Formica V, Vivaldi C, Caliman E, Rizzato MD, Zanuso V, Nichetti F, Angotti L, Landriscina M, Scartozzi M, Ramundo M, Pastorino A, Daniele B, Cornara N, Persano M, Gusmaroli E, Cerantola R, Salani F, Ratti F, Aldrighetti L, Cascinu S, Rimassa L, Antonuzzo L, Casadei-Gardini A. Durvalumab plus gemcitabine and cisplatin in advanced biliary tract cancer: An early exploratory analysis of real-world data. Liver Int. 2023;43:1803-1812. [PubMed] [DOI] [Cited in This Article: ] [Cited by in Crossref: 5] [Cited by in RCA: 33] [Article Influence: 16.5] [Reference Citation Analysis (1)] |
40. | Macias RIR, Rimassa L, Lamarca A. The promise of precision medicine: how biomarkers are shaping the future of cholangiocarcinoma treatment. Hepatobiliary Surg Nutr. 2023;12:457-461. [PubMed] [DOI] [Cited in This Article: ] [Cited by in Crossref: 2] [Cited by in RCA: 2] [Article Influence: 1.0] [Reference Citation Analysis (0)] |
41. | Du J, Lv X, Zhang Z, Huang Z, Zhang E. Revisiting targeted therapy and immunotherapy for advanced cholangiocarcinoma. Front Immunol. 2023;14:1142690. [PubMed] [DOI] [Cited in This Article: ] [Cited by in RCA: 5] [Reference Citation Analysis (0)] |
42. | Marcus L, Fashoyin-Aje LA, Donoghue M, Yuan M, Rodriguez L, Gallagher PS, Philip R, Ghosh S, Theoret MR, Beaver JA, Pazdur R, Lemery SJ. FDA Approval Summary: Pembrolizumab for the Treatment of Tumor Mutational Burden-High Solid Tumors. Clin Cancer Res. 2021;27:4685-4689. [PubMed] [DOI] [Cited in This Article: ] [Cited by in Crossref: 57] [Cited by in RCA: 280] [Article Influence: 70.0] [Reference Citation Analysis (0)] |
43. | Simile MM, Bagella P, Vidili G, Spanu A, Manetti R, Seddaiu MA, Babudieri S, Madeddu G, Serra PA, Altana M, Paliogiannis P. Targeted Therapies in Cholangiocarcinoma: Emerging Evidence from Clinical Trials. Medicina (Kaunas). 2019;55. [PubMed] [DOI] [Cited in This Article: ] [Cited by in Crossref: 35] [Cited by in RCA: 56] [Article Influence: 9.3] [Reference Citation Analysis (0)] |
44. | Kelley RK, Ueno M, Yoo C, Finn RS, Furuse J, Ren Z, Yau T, Klümpen HJ, Chan SL, Ozaka M, Verslype C, Bouattour M, Park JO, Barajas O, Pelzer U, Valle JW, Yu L, Malhotra U, Siegel AB, Edeline J, Vogel A; KEYNOTE-966 Investigators. Pembrolizumab in combination with gemcitabine and cisplatin compared with gemcitabine and cisplatin alone for patients with advanced biliary tract cancer (KEYNOTE-966): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet. 2023;401:1853-1865. [PubMed] [DOI] [Cited in This Article: ] [Cited by in Crossref: 122] [Cited by in RCA: 300] [Article Influence: 150.0] [Reference Citation Analysis (0)] |
45. | Ding Y, Han X, Sun Z, Tang J, Wu Y, Wang W. Systemic Sequential Therapy of CisGem, Tislelizumab, and Lenvatinib for Advanced Intrahepatic Cholangiocarcinoma Conversion Therapy. Front Oncol. 2021;11:691380. [PubMed] [DOI] [Cited in This Article: ] [Cited by in Crossref: 1] [Cited by in RCA: 7] [Article Influence: 1.8] [Reference Citation Analysis (0)] |
46. | Yu J, Mahipal A, Kim R. Targeted Therapy for Advanced or Metastatic Cholangiocarcinoma: Focus on the Clinical Potential of Infigratinib. Onco Targets Ther. 2021;14:5145-5160. [PubMed] [DOI] [Cited in This Article: ] [Cited by in Crossref: 12] [Cited by in RCA: 7] [Article Influence: 1.8] [Reference Citation Analysis (0)] |