The Immune Landscape and Its Potential for Immunotherapy in Advanced Biliary Tract Cancer

Biliary tract cancers (BTC) are a highly heterogeneous group of cancers at the genomic, epigenetic and molecular levels. The vast majority of patients initially present at an advanced (unresectable) disease stage due to a lack of symptoms and an aggressive tumour biology. Chemotherapy has been the m...

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Main Authors: Andry Santoso, Iris Levink, Rille Pihlak, Ian Chau
Format: Article
Language:English
Published: MDPI AG 2024-12-01
Series:Current Oncology
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Online Access:https://www.mdpi.com/1718-7729/32/1/24
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author Andry Santoso
Iris Levink
Rille Pihlak
Ian Chau
author_facet Andry Santoso
Iris Levink
Rille Pihlak
Ian Chau
author_sort Andry Santoso
collection DOAJ
description Biliary tract cancers (BTC) are a highly heterogeneous group of cancers at the genomic, epigenetic and molecular levels. The vast majority of patients initially present at an advanced (unresectable) disease stage due to a lack of symptoms and an aggressive tumour biology. Chemotherapy has been the mainstay of treatment in patients with advanced BTC but the survival outcomes and prognosis remain poor. The addition of immune checkpoint inhibitors (ICI) to chemotherapy have shown only a marginal benefit over chemotherapy alone due to the complex tumour immune microenvironment of these cancers. This review appraises our current understanding of the immune landscape of advanced BTC, including emerging transcriptome-based classifications, highlighting the mechanisms of immune evasion and resistance to ICI and their therapeutic implications. It describes the shifting treatment paradigm from traditional chemotherapy to immunotherapy combinations as well as the potential biomarkers for predicting response to ICI.
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language English
publishDate 2024-12-01
publisher MDPI AG
record_format Article
series Current Oncology
spelling doaj-art-4e05332e6f2f47e197ee4c4af7eaa2ba2025-01-24T13:28:23ZengMDPI AGCurrent Oncology1198-00521718-77292024-12-013212410.3390/curroncol32010024The Immune Landscape and Its Potential for Immunotherapy in Advanced Biliary Tract CancerAndry Santoso0Iris Levink1Rille Pihlak2Ian Chau3Gastrointestinal Unit, The Royal Marsden Hospital, London SW3 6JJ, UKGastrointestinal Unit, The Royal Marsden Hospital, London SW3 6JJ, UKUniversity Hospitals Sussex NHS Foundation Trust, Brighton BN1 9RW, UKGastrointestinal Unit, The Royal Marsden Hospital, London SW3 6JJ, UKBiliary tract cancers (BTC) are a highly heterogeneous group of cancers at the genomic, epigenetic and molecular levels. The vast majority of patients initially present at an advanced (unresectable) disease stage due to a lack of symptoms and an aggressive tumour biology. Chemotherapy has been the mainstay of treatment in patients with advanced BTC but the survival outcomes and prognosis remain poor. The addition of immune checkpoint inhibitors (ICI) to chemotherapy have shown only a marginal benefit over chemotherapy alone due to the complex tumour immune microenvironment of these cancers. This review appraises our current understanding of the immune landscape of advanced BTC, including emerging transcriptome-based classifications, highlighting the mechanisms of immune evasion and resistance to ICI and their therapeutic implications. It describes the shifting treatment paradigm from traditional chemotherapy to immunotherapy combinations as well as the potential biomarkers for predicting response to ICI.https://www.mdpi.com/1718-7729/32/1/24cholangiocarcinomabiliary tract cancerimmune microenvironmentimmunotherapy
spellingShingle Andry Santoso
Iris Levink
Rille Pihlak
Ian Chau
The Immune Landscape and Its Potential for Immunotherapy in Advanced Biliary Tract Cancer
Current Oncology
cholangiocarcinoma
biliary tract cancer
immune microenvironment
immunotherapy
title The Immune Landscape and Its Potential for Immunotherapy in Advanced Biliary Tract Cancer
title_full The Immune Landscape and Its Potential for Immunotherapy in Advanced Biliary Tract Cancer
title_fullStr The Immune Landscape and Its Potential for Immunotherapy in Advanced Biliary Tract Cancer
title_full_unstemmed The Immune Landscape and Its Potential for Immunotherapy in Advanced Biliary Tract Cancer
title_short The Immune Landscape and Its Potential for Immunotherapy in Advanced Biliary Tract Cancer
title_sort immune landscape and its potential for immunotherapy in advanced biliary tract cancer
topic cholangiocarcinoma
biliary tract cancer
immune microenvironment
immunotherapy
url https://www.mdpi.com/1718-7729/32/1/24
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