Materiały źródłowe

• #1 Bile Duct Cancer (Cholangiocarcinoma) Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/liver/hp/bile-duct-treatment-pdq

  Cancer of the bile duct (also called cholangiocarcinoma) is extremely rare. The treatment of bile duct cancer depends primarily on whether the cancer can be completely removed by surgery. Localized intrahepatic and extrahepatic bile duct cancer may be completely removed by surgery. These tumors represent a very small number of cases and are usually in the distal common bile duct. Among patients treated with surgical resection, long-term prognosis varies depending on primary tumor extent, margin status, lymph node involvement, and additional pathological features. Extended resections of hepatic duct bifurcation tumors (Klatskin tumors, also known as hilar tumors) to include adjacent liver, either by lobectomy or removal of portions of segments 4 and 5 of the liver, may be performed. If major hepatic resection is necessary to achieve a complete resection, postoperative hepatic reserve should be evaluated. For patients with underlying cirrhosis, the Child-Pugh class and the Model for End-Stage Liver Disease score are determined.

• #2 Cholangiocarcinoma Treatment & Management: Approach Considerations, Stent Placement, Photodynamic Therapy

  https://emedicine.medscape.com/article/277393-treatment

  Complete surgical resection is the only therapy to afford a chance of cure. Unfortunately, only 10% of patients present with early-stage disease and are candidates for curative resection. […] Palliative procedures are required if internal stenting cannot be accomplished and/or external stenting is not desirable or cannot be obtained. Surgical bypass, particularly for tumors in the common bile duct, should be performed in such cases.

• #3 Bile Duct Cancer (Cholangiocarcinoma) Treatment – PDQ Cancer Information Summaries – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK65851/

  Bile Duct Cancer Treatment: This page describes the different types of treatment for bile duct cancer (cholangiocarcinoma). Which of these treatments a person receives will depend on whether the cancer can be completely removed with surgery (resectable) or not (unresectable). To learn more, see treatment of resectable and treatment of unresectable bile duct cancer. […] The following types of surgery are used to treat bile duct cancer: Removal of the bile duct: This surgical procedure is done to remove part of the bile duct if the tumor is small and is in the bile duct only. Lymph nodes are removed and tissue from the lymph nodes is viewed under a microscope to see if there is cancer. Partial hepatectomy: This is a surgical procedure to remove the part of the liver where cancer is found. The part removed may be a wedge of tissue, an entire lobe, or a larger part of the liver, along with some normal tissue around it. Whipple procedure: During this surgical procedure the head of the pancreas, the gallbladder, part of the stomach, part of the small intestine, and the bile duct are removed. Enough of the pancreas is left to make digestive juices and insulin.

• #4 Cholangiocarcinoma (bile duct cancer) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/cholangiocarcinoma/diagnosis-treatment/drc-20352413

  Treatments for cholangiocarcinoma (bile duct cancer) may include: […] Surgery. When possible, surgeons try to remove as much of the cancer as they can. For very small bile duct cancers, this involves removing part of the bile duct and joining the cut ends. For more-advanced bile duct cancers, nearby liver tissue, pancreas tissue or lymph nodes may be removed as well. […] Liver transplant. Surgery to remove your liver and replace it with one from a donor (liver transplant) may be an option in certain situations for people with hilar cholangiocarcinoma. For many, a liver transplant can be a cure for hilar cholangiocarcinoma, but there is a risk that the cancer will recur after a liver transplant. […] Chemotherapy. Chemotherapy uses drugs to kill cancer cells. Chemotherapy may be used before a liver transplant. It may also be an option for people with advanced cholangiocarcinoma to help slow the disease and relieve signs and symptoms. Chemotherapy drugs can be infused into a vein so that they travel throughout the body. Or the drugs can be administered in a way so that they are delivered directly to the cancer cells.

• #5 Bile Duct Cancer (Cholangiocarcinoma) Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/liver/hp/bile-duct-treatment-pdq

  Most cases of intrahepatic, distal, and perihilar bile duct cancer are unresectable and cannot be completely removed. Often the cancer directly invades the portal vein, the adjacent liver, along the common bile duct, and the adjacent lymph nodes. […] Treatment options for bile duct cancer are described in Table 16. […] Complete surgical resection with negative surgical margins offers the only chance of cure for distal bile duct cancers. Bile duct tumors can be difficult to resect because of their proximity to major blood vessels and diffuse infiltration of adjacent bile ducts. Total resection is possible in 25% to 30% of lesions that originate in the distal bile duct. The resectability rate is lower for lesions that occur in more proximal sites. […] Numerous retrospective series have suggested that adjuvant chemotherapy after complete surgical resection may be beneficial. However, prospective randomized trials have failed to consistently show a significant benefit in overall survival (OS).

• #6 Cholangiocarcinoma – Wikipedia

  https://en.wikipedia.org/wiki/Cholangiocarcinoma

  Cholangiocarcinoma is considered to be an incurable and rapidly lethal disease unless all the tumors can be fully resected (cut out surgically). […] In 2008, the Mayo Clinic reported significant success treating early bile duct cancer with liver transplantation using a protocolized approach and strict selection criteria. […] Adjuvant therapy followed by liver transplantation may have a role in treatment of certain unresectable cases. […] Locoregional therapies including transarterial chemoembolization (TACE), transarterial radioembolization (TARE) and ablation therapies have a role in intrahepatic variants of cholangiocarcinoma to provide palliation or potential cure in people who are not surgical candidates. […] If the tumor can be removed surgically, people may receive adjuvant chemotherapy or radiation therapy after the operation to improve the chances of cure.

• #7 Management of Cholangiocarcinoma (Bile Duct Cancer) | Section of Abdominal Transplant Surgery | Washington University in St. Louis

  https://transplantsurgery.wustl.edu/bile-duct/current-management-of-cholangiocarcinoma-bile-duct-cancer/

  Washington University liver surgeons at Barnes-Jewish Hospital offer the option of liver removal and liver transplantation to patients with cholangiocarcinoma (bile duct cancer) confined to the bile ducts. […] The preferred treatment of cholangiocarcinoma is surgical removal, and this usually can be performed for cholangiocarcinomas that arise in the liver or in the lower end of the bile duct within the pancreas gland (usually with the Whipple procedure). […] When we treat a patient with a Klatskin tumor, our preferred approach is always standard surgical removal; however, when this is not possible, we now consider liver transplantation as a treatment option. […] Patients with cholangiocarcinoma who are not candidates for removal but are eligible for liver transplantation undergo radiologic imaging and laparoscopic examination to ensure there is no cancer outside of the bile ducts and liver. They receive courses in chemotherapy and chemoradiation to control their cancers. […] Both the cancer and the obstruction are treated in patients with cholangiocarcinoma. Surgical removal is the treatment of choice when it is possible. […] Palliative treatment to clear obstructions and relieve jaundice may be undertaken in patients with unresectable disease.

• #8 Treatment Options – Cholangiocarcinoma Australia

  https://cholangiocarcinomaaustralia.org/treatment-options/

  For resectable cancers, the type of operation depends on the cancers location. […] Surgery for these cancers requires great skill, as the operation is quite extensive. […] This is a complex procedure that requires a specialized surgical team. […] Surgery for bile duct cancer is a major operation that might mean removing parts of several organs. […] The American Association for the Study of Liver disease Guidelines recommends that potential transplant candidates should be expeditiously referred to major cancer centers that have established protocols for oncologic assessment and treatment approved by United Network for Organ Sharing (UNOS). […] For some people with early-stage unresectable intrahepatic or perihilar bile duct cancers, removing the liver and bile ducts and then transplanting a donor liver may be an option.

• #9 Bile Duct Cancer (Cholangiocarcinoma) Treatment – PDQ Cancer Information Summaries – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK65851/

  After the doctor removes all the cancer that can be seen at the time of the surgery, some people may receive chemotherapy or radiation therapy to kill any cancer cells that are left. Treatment given after surgery to lower the risk that the cancer will come back is called adjuvant therapy. It is not yet known whether chemotherapy or radiation therapy given after surgery helps keep the cancer from coming back. […] Radiation therapy uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. These are the main ways radiation might be given to treat bile duct cancer: External radiation therapy: A machine outside the body sends radiation toward the area of the body with cancer. Radiation is given in a series of treatments to allow healthy cells to recover and to make radiation more effective.

• #10 Bile Duct Cancer (Cholangiocarcinoma) Treatment: Treatment – Patient Information [NCI] | Cigna

  https://www.cigna.com/knowledge-center/hw/medical-topics/bile-duct-cancer-treatment-ncicdr0000258011

  Whipple procedure: During this surgical procedure the head of the pancreas, the gallbladder, part of the stomach, part of the small intestine, and the bile duct are removed. Enough of the pancreas is left to make digestive juices and insulin. […] After the doctor removes all the cancer that can be seen at the time of the surgery, some people may receive chemotherapy or radiation therapy to kill any cancer cells that are left. Treatment given after surgery to lower the risk that the cancer will come back is called adjuvant therapy. It is not yet known whether chemotherapy or radiation therapy given after surgery helps keep the cancer from coming back. […] The following types of palliative surgery may be done to relieve symptoms caused by a blocked bile duct and improve quality of life: […] Biliary bypass: If cancer is blocking the bile duct and bile is building up in the gallbladder, a biliary bypass may be done. During this operation, the doctor will cut the gallbladder or bile duct in the area before the blockage and sew it to the part of the bile duct that is past the blockage or to the small intestine. This type of surgery creates a new pathway around the blocked area.

• #11 Bile Duct Cancer (Cholangiocarcinoma) Treatment: Treatment – Patient Information [NCI] | Cigna

  https://www.cigna.com/knowledge-center/hw/medical-topics/bile-duct-cancer-treatment-ncicdr0000258011

  Endoscopic stent placement: If the tumor is blocking the bile duct, surgery may be done to put in a stent (a thin, flexible tube) to drain bile that has built up in the area. The doctor may place the stent through a catheter that drains the bile into a bag on the outside of the body or the stent may go around the blocked area and drain the bile into the small intestine. […] Percutaneous transhepatic biliary drainage: This procedure is used to x-ray the liver and bile ducts. A thin needle is inserted through the skin below the ribs and into the liver. Dye is injected into the liver or bile ducts and an x-ray is taken. If the bile duct is blocked, a stent may be left in the liver to drain bile into the small intestine or a collection bag outside the body. […] Radiation therapy […] Radiation therapy uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. These are the main ways radiation might be given to treat bile duct cancer:

• #12 Treatment options for bile duct cancer | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/bile-duct-cancer/treatment/treatment-options

  It might be a: different combination of chemotherapy drugs, targeted cancer drug or immunotherapy. […] Which second line treatment you have depends on whether the cancer has any gene changes (mutations) or not. […] You might also have other treatments to help control your symptoms. […] Bile duct cancer can cause symptoms such as: weight loss, pain in the tummy (abdomen), yellowing of the skin and eyes – this is called jaundice. […] You usually see the symptom control team (palliative care team). They help to manage your symptoms. You might have different treatments depending on the type of symptoms you have. This might include painkillers and anti-sickness medicines. […] Some people may have radiotherapy to help control the symptoms of advanced bile duct cancer. […] Bile duct cancer can block the bile ducts and cause jaundice. Your doctor usually puts a tube called a stent in your bile duct to open it. This means the bile can flow again.

• #13 7 Innovative Bile Duct Cancer (Cholangiocarcinoma) Treatment Options | MD Anderson Cancer Center

  https://www.mdanderson.org/cancer-types/bile-duct-cancer/bile-duct-cancer-treatment.html

  MD Anderson has experts with years of experience treating bile duct and gallbladder cancer with surgery, radiation and chemotherapy. Choosing a treatment depends on the disease stage, a patients physical condition and tumor characteristics. MD Andersons treatment approach is individualized for every patient. […] Complete removal of the tumor is the most effective biliary cancer treatment. This may be possible depending on the location of the tumor along the bile duct. This surgery is most often offered to patients with early-stage disease who are in good physical condition. […] Radiation therapy uses focused, high-energy radiation beams to destroy cancer cells. It can improve survival and provide a chance of a cure or prolonged disease control in patients who dont receive surgery. […] Most biliary cancers are discovered at an advanced stage when surgical treatment options are limited. Chemotherapy works by killing fast growing cells, including cancer cells, all over the body. It is typically used to control the spread of the cancer, alleviate symptoms and improve overall survival.

• #14 Chemotherapy for Bile Duct Cancer (Cholangiocarcinoma) | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/types/bile-duct-cancer-cholangiocarcinoma/treatment/chemotherapy

  Medical oncologist Ghassan Abou-Alfa and his clinical team work closely to ensure that chemotherapy and other treatments are well-coordinated. This provides patients with the highest level of care. […] Chemotherapy is a drug or a combination of drugs that kills cancer cells wherever they are in the body. You may receive chemotherapy before surgery to shrink a bile duct tumor. This is called neoadjuvant therapy. If you receive chemotherapy after surgery to destroy and cancer cells that may remain, it is called adjuvant therapy. […] The standard chemotherapy drugs for bile duct cancer are gemcitabine (Gemzar) and cisplatin. Other drugs sometimes used include fluorouracil (also called 5-FU), oxaliplatin (Eloxatin), and capecitabine (Xeloda). We will carefully tailor your treatment to make sure that its as effective as possible while helping maintain your quality of life.

• #15 Bile Duct Cancer (Cholangiocarcinoma) Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/liver/hp/bile-duct-treatment-pdq

  For patients with unresectable bile duct cancer, management is directed at palliation. […] Systemic chemotherapy is appropriate for selected patients with adequate performance status and intact organ function. […] Pending further clinical trials, cisplatin plus gemcitabine is considered the reference standard first-line chemotherapy backbone for patients with unresectable, metastatic, or recurrent bile duct cancer. […] Patients with targetable pathogenic variants can consider clinical trials of investigational therapies. Currently, targeted therapies have only been approved for patients whose disease has progressed or who are ineligible for first-line therapies. […] All patients are encouraged to enroll in clinical trials for adjuvant therapies. Information about ongoing clinical trials is available from the NCI website.

• #16 Bile Duct Cancer (Cholangiocarcinoma) Treatment (PDQ®): Treatment – Health Professional Information [NCI] | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.bile-duct-cancer-cholangiocarcinoma-treatment-pdq%C2%AE-treatment-health-professional-information-nci.ncicdr0000062905

  Pending further clinical trials, cisplatin plus gemcitabine is considered the reference standard first-line chemotherapy backbone for patients with unresectable, metastatic, or recurrent bile duct cancer. […] Based on results from the TOPAZ-1 and KEYNOTE-966 trials, all patients with unresectable, metastatic, or recurrent disease should consider treatment with a checkpoint inhibitor (either durvalumab or pembrolizumab) with cisplatin and gemcitabine. […] Clinical trials of investigational therapies should be considered for patients with targetable mutations.

• #17 The new insight of treatment in Cholangiocarcinoma

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8771522/

  Surgical resection of PCCA is a potential treatment option for patients with PCCA without the following exclusion barriers: bilateral secondary bile duct involvement, bilateral or contralateral vascular involvement, presence of metastatic disease, and underlying primary sclerosing cholangitis (PSC). […] Chemotherapy plays a certain role in delaying the progression of the disease for patients who are inoperable, even some inoperable patients can receive surgical treatment after induction treatment to obtain higher therapeutic effects. […] According to the 2021 NCCN guidelines, regardless of anatomic disease subtype, and the tumor is or not applicable to local and surgical options, the combination of Gemcitabine and Cisplatin remains the current first-line chemotherapy regimen for patients with advanced CCA.

• #18 Bile Duct Cancer (Cholangiocarcinoma) Treatment: Treatment – Patient Information [NCI] | Cigna

  https://www.cigna.com/knowledge-center/hw/medical-topics/bile-duct-cancer-treatment-ncicdr0000258011

  gemcitabine and cisplatin […] capecitabine and oxaliplatin (XELOX) […] gemcitabine and oxaliplatin (GEMOX) […] gemcitabine and capecitabine […] Regional chemotherapy: When chemotherapy is placed directly into an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas. […] Intra-arterial embolization is being studied in the treatment of unresectable, metastatic, or recurrent bile duct cancer. It is a procedure in which the blood supply to a tumor is blocked after anticancer drugs are given in blood vessels near the tumor. Sometimes, the anticancer drugs are attached to small beads that are injected into an artery that feeds the tumor. The beads block blood flow to the tumor as they release the drug. This allows a higher amount of drug to reach the tumor for a longer period of time, which may kill more cancer cells.

• #19 Clinical treatment of cholangiocarcinoma: an updated comprehensive review | Annals of Hepatology

  https://www.elsevier.es/en-revista-annals-hepatology-16-articulo-clinical-treatment-cholangiocarcinoma-an-updated-S1665268122000795

  After the radical surgical approach, the available treatments for BTC are chemotherapy and radiotherapy, or a combination of the two. […] The first positive, large, randomized phase III trial was the BILCAP-study, which compared 8 cycles of capecitabine to surveillance: the median OS was 36.4 months for the control group and 51.1 months in the experimental arm. […] Several pivotal trials for metastatic setting in biliary disease are ongoing. […] Treatment strategies for unresectable CCA. First line treatment for unresectable CCA is chemotherapy (CT), with gemcitabine and cisplatin; different agents have been proposed as second line chemotherapy and a clinical trial with FOLFOX is still ongoing in this setting. […] Target therapies against different molecular targets and immunotherapy have been proposed in the last few years as second and third line of treatment, alone or in combination.

• #20 Chemotherapy for Bile Duct Cancer (Cholangiocarcinoma) | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/types/bile-duct-cancer-cholangiocarcinoma/treatment/chemotherapy

  If you have bile duct cancer that has spread, you may receive chemotherapy as the main treatment if surgery is not an option. Research has suggested that the combination of gemcitabine and cisplatin can lengthen the lives of people with bile duct cancer that cannot be removed by surgery. […] Chemotherapy is also occasionally given to relieve symptoms due to bile duct cancer, such as a tumor that is pressing on a nerve and causing pain. […] MSK researchers are evaluating the potential of a new chemotherapy technique called hepatic arterial infusion (HAI) in the treatment of bile duct cancer. HAI involves delivering a high dose of chemotherapy drugs directly to the liver through a tiny pump implanted under the skin in the lower belly. The chemotherapy passes from the liver into the bile ducts. HAI therapy may be used to shrink tumors before surgery.

• #21 Bile Duct Cancer | OHSU

  https://www.ohsu.edu/knight-cancer-institute/bile-duct-cancer

  A light at the end of the tube is turned on, activating the medication and killing the cancer cells. This option may help when surgery isn’t possible. […] Chemotherapy uses medications to kill cancer cells nearly anywhere in your body. It may be given by mouth or IV. […] It’s not effective for many types of bile duct cancer but may be used: […] After surgery, to keep cancer from returning. […] To shrink a tumor before surgery. […] As palliative therapy, to shrink or slow tumors. This can relieve pain or other symptoms. […] We are one of the few cancer centers in the U.S. to offer hepatic arterial infusion (HAI) therapy. Doctors place a pump in your belly to deliver a powerful dose of chemotherapy into your hepatic artery, which supplies blood to most bile duct tumors. This helps shrink the tumor with minimal side effects. The Knight is a national leader in HAI therapy for bile duct cancer.

• #22 Treatment Options – Cholangiocarcinoma Australia

  https://cholangiocarcinomaaustralia.org/treatment-options/

  This type of surgery is performed when the tumor is too widespread to be completely removed. […] Palliative surgery is not expected to cure the cancer, but it can sometimes help someone feel better and sometimes can even help them live longer. […] Radiation therapy can also be used as a therapy for patients whose cancer has not spread widely throughout the body but is not resectable. […] Chemoradiation is a therapy for some advanced cholangiocarcinomas. […] Palliative therapy using radiation is often used to palliate (relieve) symptoms when a patients cancer is too advanced to be cured. […] Radiofrequency ablation (RFA) offers a nonsurgical, localized treatment that kills the tumor cells with heat, while sparing the healthy liver tissue. […] Chemoembolization is a minimally invasive treatment for liver cancer that can be used when there is too much tumor to treat with radiofrequency ablation (RFA).

• #23 Gallbladder Cancer Diagnosis and Treatment | Memorial Cancer InstituteHealthcare System

  https://www.mhs.net/services/cancer-care/conditions-treatments-and-services/gastrointestinal-cancer/cholangiocarcinoma-and-gallbladder-cancer

  We also offer a range of nonsurgical treatments to treat these cancers: Chemotherapy (chemo) is a medication that is injected or swallowed to destroy cancer cells. Chemo can cause several side effects, and your care team will help you prevent or manage them. […] Radiation uses high-energy rays or particles to destroy cancer cells. This treatment can slow or control a tumors growth, shrink a tumor before surgery, destroy remaining cancer cells after surgery or ease symptoms. Memorial offers several types of radiation therapy. […] New treatments can target certain genes or proteins that contribute to biliary cancer growth. Targeted therapy is especially effective against cancers with specific tumor markers, and this therapy often involves fewer side effects. We test patients routinely to see if any genes or proteins can be targeted for treatment.

• #24 Treatment for bile duct cancer – NHS

  https://www.nhs.uk/conditions/bile-duct-cancer/treatment/

  You may have immunotherapy if the cancer has spread to another part of your body. […] Radiotherapy is not often used to treat bile duct cancer. But you may have radiotherapy: after surgery to help stop the cancer coming back, to help control and improve the symptoms of advanced cancer, with chemotherapy (chemoradiotherapy). […] If you have advanced bile duct cancer it might be very hard to treat. It may not be possible to cure the cancer. […] If this is the case, the aim of your treatment will be to limit the cancer and its symptoms, and help you live longer.

• #25

  https://ammf.org.uk/treatment-options/

  There are now a number of approved treatments for those with cholangiocarcinoma. […] Radiotherapy, which uses high energy x-rays to destroy cancer cells, is not routinely used to treat cholangiocarcinoma, although there may be occasions when it is used palliatively (to reduce symptoms). […] Clinical trials continue to investigate ways to better, more effective treatments.

• #26 Bile Duct Cancer Treatment – NCI

  https://www.cancer.gov/types/liver/bile-duct-cancer/treatment

  Chemotherapy uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. There are two main types of chemotherapy used to treat bile duct cancer. […] In a liver transplant, the entire liver is removed and replaced with a healthy donated liver. A liver transplant may be done in people with perihilar bile duct cancer. […] Targeted therapy is a type of treatment that uses drugs or other substances to identify and attack specific cancer cells. […] Immunotherapy helps a persons immune system fight cancer. […] If the cancer has not spread and is in a place where surgery can be safely done, the tumor and some of the tissue around it will be removed. This lowers the chance of the cancer coming back. Chemotherapy with or without radiation therapy may be given after surgery. […] Most people with bile duct cancer cannot have their cancer completely removed with surgery. This may be the case if the cancer has spread too far, the cancer is in a place that is too difficult to completely remove with surgery, or the patient is not healthy enough for surgery.

• #27 Bile Duct Cancer (Cholangiocarcinoma) Treatment – PDQ Cancer Information Summaries – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK65851/

  After the doctor removes all the cancer that can be seen at the time of the surgery, some people may receive chemotherapy or radiation therapy to kill any cancer cells that are left. Treatment given after surgery to lower the risk that the cancer will come back is called adjuvant therapy. It is not yet known whether chemotherapy or radiation therapy given after surgery helps keep the cancer from coming back. […] Radiation therapy uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. These are the main ways radiation might be given to treat bile duct cancer: External radiation therapy: A machine outside the body sends radiation toward the area of the body with cancer. Radiation is given in a series of treatments to allow healthy cells to recover and to make radiation more effective.

• #28 Cholangiocarcinoma (bile duct cancer) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/cholangiocarcinoma/diagnosis-treatment/drc-20352413

  Radiation therapy. Radiation therapy uses high-powered energy beams from sources such as X-rays and protons to kill cancer cells. Radiation therapy can involve a machine that directs radiation beams at your body (external beam radiation). Or it can involve placing radioactive material inside your body near the site of your cancer (brachytherapy). […] Targeted drug therapy. Targeted drug treatments focus on specific abnormalities present within cancer cells. By blocking these abnormalities, targeted drug treatments can cause cancer cells to die. Your doctor may test your cancer cells to see if targeted therapy may be effective against your cholangiocarcinoma. […] Immunotherapy. Immunotherapy uses your immune system to fight cancer. Your body’s disease-fighting immune system may not attack your cancer because the cancer cells produce proteins that help them hide from the immune system cells. Immunotherapy works by interfering with that process. For cholangiocarcinoma, immunotherapy might be an option for advanced cancer when other treatments haven’t helped.

• #29 Bile duct cancer | NHS inform

  https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/bile-duct-cancer-cholangiocarcinoma/

  In cases of stage 4 bile duct cancer, achieving a successful cure is highly unlikely. However, stenting, chemotherapy, radiotherapy and surgery can often be used to help relieve the symptoms. […] If your MDT thinks it is possible to cure your bile duct cancer, surgery will be needed to remove any cancerous tissue. […] After surgery, it is usually possible to reconstruct what remains of the bile duct so that bile can still flow into the intestine. […] The bile duct can be unblocked by using a small tube called a stent. The stent widens the bile duct, which should help to get the bile flowing again. […] Radiotherapy is not a standard treatment for bile duct cancer, but may help to relieve the symptoms, slow the spread of the cancer and prolong life. […] Chemotherapy is used in a similar way to radiotherapy to relieve the symptoms of cancer, slow down the rate it spreads and prolong life. […] A number of clinical trials are being conducted to find better ways of treating the condition. […] Another promising field of research involves using targeted therapies to treat bile duct cancer.

• #30 7 Innovative Bile Duct Cancer (Cholangiocarcinoma) Treatment Options | MD Anderson Cancer Center

  https://www.mdanderson.org/cancer-types/bile-duct-cancer/bile-duct-cancer-treatment.html

  Targeted therapy is an important area of biliary cancer research. Several genetic mutations are treatment targets for biliary cancer. Targeted therapies seek out and destroy these abnormalities within cancer cells. Targeted therapies are given orally or by IV injection. […] MD Anderson is developing new treatments and clinical trials to improve the prognosis and survival of patients with biliary cancers. […] Bile duct cancer is treated in our Gastrointestinal Center. […] Biliary cancers are relatively uncommon diseases that can occur in the bile ducts within or outside of the liver, as well as in the gallbladder. Radiation therapy for biliary cancer may be given after surgery to control a tumor from spreading or instead of surgery to provide relief from symptoms. […] Common radiation approaches for biliary cancer treatment include intensity modulated radiation therapy (IMRT) or stereotactic body radiation therapy (SBRT). These photon-based approaches use image guidance to send high dose radiation directly to the tumor.

• #31 Bile Duct Cancer – What to Expect | IU Health

  https://iuhealth.org/find-medical-services/bile-duct-cancer

  Palliative care. Relieving pain and symptoms to improve your quality of life. […] Liver transplantation. In rare cases, a liver transplant may be considered for highly selected patients with bile duct cancer. […] Radiation therapy treatments may include: Computed tomography (CT) simulation. A radiation planning process using a CT scan defines tumor targets and internal anatomy in three dimensions, allowing the radiation oncologist to precisely target the tumor while saving healthy tissue. […] Four-dimensional CT simulation. A CT simulation that visualizes internal anatomy changes (such as changes in tumor location with the breathing cycle) allowing the radiation oncologist to target the tumor more accurately and further spare healthy tissue. […] Image guided radiation therapy (IGRT). Uses precise radiographic imaging to precisely target tumors while sparing healthy tissue.

• #32 Bile Duct Cancer – What to Expect | IU Health

  https://iuhealth.org/find-medical-services/bile-duct-cancer

  Cone-beam computed tomography (CBCT). An IGRT technique that uses a limited CT scan prior to daily radiation. This technique allows extreme precision in targeting the radiation beams. […] Three-dimensional conformal radiotherapy. Guided by a computer-generated three-dimensional picture of the tumor, allowing the highest possible dose of radiation while sparing healthy tissue as much as possible. […] Intensity modulated radiation therapy (IMRT). Advanced radiation technology that allows precise delivery of radiation to areas near or around radiation-sensitive tissues, using a computerized optimization algorithm. […] Stereotactic body radiation therapy (SBRT). Special equipment delivers precise, high-dose radiation to a tumor without affecting healthy tissue. […] Proton beam radiation. Particle radiation that treats tumors in close proximity to critical, radiation-sensitive tissue.

• #33 What is Cholangiocarcinoma (Bile Duct Cancer) and Gallbladder Cancer? | Mount Sinai – New York

  https://www.mountsinai.org/care/cancer/services/liver/cholangiocarcinoma

  If you have bile duct cancer or gallbladder cancer, you are in good hands at Mount Sinai; we have extensive experience diagnosing and treating these conditions. […] We use several types of treatments for biliary cancers. These include surgery, chemotherapy, radiation, and organ transplantation. […] Surgical procedures for cholangiocarcinoma and gallbladder cancer are complex. Intrahepatic cholangiocarcinomas and gallbladder cancers are often large and involve nearby structures. Surgery for hilar cholangiocarcinoma usually involves removing part of the liver and part of the bile duct. […] Chemotherapy plays an important role in treating cholangiocarcinoma and gallbladder cancer. You may receive chemotherapy before surgery (neoadjuvant) and/or after surgery (adjuvant). […] When cholangiocarcinoma is too advanced in the liver for us to remove it but has not spread anywhere else, we often provide radiation treatment as well, to help us control cancer growth longer. […] For these patients, we offer liver transplantation, combined with radiation and chemotherapy. Mount Sinai is one of a few centers in the United States to offer this treatment.

• #34 Bile Duct Cancer Targeted Therapy | Cholangiocarcinoma Targeted Therapy | American Cancer Society

  https://www.cancer.org/cancer/types/bile-duct-cancer/treating/targeted-therapy.html

  As researchers learn more about the changes in cells that cause cancer, they’ve developed drugs to target some of these changes. These targeted drugs work differently from standard chemotherapy (chemo) drugs, and they often have different side effects. This type of treatment blocks the growth and spread of cancer cells and limits damage to healthy cells. […] FGFRs (fibroblast growth factor receptors) are proteins on cells that help them grow and divide normally. A small number of people with bile duct cancer within the liver have changes in the genes that make FGFRs. These changes result in abnormal FGFR proteins that cause cells to grow out of control and turn into cancer. […] Pemigatinib (Pemazyre) and futibatinib (Lytgobi) are FGFR2 inhibitors. They block the abnormal FGFR2 protein in bile duct cancer cells and keep them from growing and spreading to other places.

• #35 Bile Duct Cancer Targeted Therapy | Cholangiocarcinoma Targeted Therapy | American Cancer Society

  https://www.cancer.org/cancer/types/bile-duct-cancer/treating/targeted-therapy.html

  These drugs can be used to treat some advanced bile duct cancers that cannot be removed by surgery or have spread to distant areas after at least one previous chemotherapy treatment. For these drugs to work, your cancer must have an abnormal FGFR2 gene, so your cancer will be tested before you start any of these drugs. […] Ivosidenib (Tibsovo) is an IDH1 inhibitor. It blocks the abnormal IDH1 protein, which seems to help the cancer cells mature into more normal cells. This drug can be used in people with advanced, previously treated bile duct cancer if the cancer cells are found to have an IDH1 mutation. […] Larotrectinib (Vitrakyi), entrectinib (Rozlytrek), and repotrectinib (Augtyro) are TRK inhibitors. TRK inhibitors target and disable the proteins made by the NTRK genes. These drugs can be used in people with advanced bile duct cancer who have not received prior systemic therapy.

• #36 Cholangiocarcinoma – Wikipedia

  https://en.wikipedia.org/wiki/Cholangiocarcinoma

  The majority of cases of cholangiocarcinoma present as inoperable (unresectable) disease in which case people are generally treated with palliative chemotherapy, with or without radiotherapy. […] Chemotherapy has been shown in a randomized controlled trial to improve quality of life and extend survival in people with inoperable cholangiocarcinoma. […] There is no single chemotherapy regimen which is universally used, and enrollment in clinical trials is often recommended when possible. […] Infigratinib (Truseltiq) is a tyrosine kinase inhibitor of fibroblast growth factor receptor (FGFR) that was approved for medical use in the United States in May 2021. […] It is indicated for the treatment of people with previously treated locally advanced or metastatic cholangiocarcinoma harboring an FGFR2 fusion or rearrangement.

• #37 Bile Duct Cancer Targeted Therapy | Cholangiocarcinoma Targeted Therapy | American Cancer Society

  https://www.cancer.org/cancer/types/bile-duct-cancer/treating/targeted-therapy.html

  Selpercatinib (Retevmo) and pralsetinib (Gayreto) are RET inhibitors and can be used to treat advanced bile duct cancers with the RET rearrangement. […] Dabrafenib (Tafinlar) is a BRAF inhibitor. Trametinib (Mekinist) is a MEK inhibitor. This drug combination can be used in people with advanced, previously treated bile duct cancer if the cancer cells are found to have a BRAF V600E mutation. […] Adagrasib (Krazati) is a KRAS inhibitor and is used to treat advanced bile duct cancer with the KRAS G12C mutation in people who’ve already had at least one other type of drug treatment. […] Zanidatamab (Ziihera) is a medicine that attaches to 2 different parts of the HER2 protein. It can be used to treat HER2-positive bile duct cancer that can’t be removed completely or that has spread to other parts of the body, if other treatments have already been tried.

• #38 Bile Duct Cancer | Causes, Symptoms, Treatment & Support | Guts UK

  https://gutscharity.org.uk/advice-and-information/conditions/bile-duct-cancer/

  Chemotherapy is sometimes used before surgery to reduce the size of the cancer. This may increase the chance of completely removing the cancer. This increases the chance of survival. This is called neoadjuvant therapy. Doctors may also use chemotherapy after surgery. It reduces the risk of the cancer coming back. This treatment is called adjuvant chemotherapy. There are various types of chemotherapy for bile duct cancer. […] Newer cancer therapies treat cancer precisely. They are called targeted therapy. They are also called precision medicine. How the cancer responds to treatment may vary. It depends on the genetic type of the cancer, which varies from person to person. Recently, England, Wales, and Scotland approved a drug called pemigatinib. This treatment is for people who cannot have the tumour removed by surgery. It is either locally advanced or has spread to other parts of the body. Doctors use it when they find fibroblast growth factor receptor 2 (FGFR2) in the cancer cells. This receptor is identified by molecular testing. Pemigatinib blocks the FGFR2 receptor. This stops cancer from growing and spreading.

• #39 The new insight of treatment in Cholangiocarcinoma

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8771522/

  In the NCCN guidelines, for patients with CCA with positive resection margins or regional LNM under the microscope or naked eye, radiotherapy is recommended after surgery, and this treatment is also considered to be locally advanced unresectable CCA an effective local treatment method. […] Targeted therapy is a treatment method that targets the identified carcinogenic sites at the cellular and molecular level. […] Immune checkpoint inhibitors are the focus of immunotherapy in recent years. Their anti-tumor effects are mainly through blocking immune detection sites, re-establishing normal anti-tumor immunity, restoring or improving the body’s anti-tumor immune response, and thus controlling and clearing tumors. […] Transcatheter arterial chemoembolization (TACE) is one of the first-line treatment options for patients with unresectable ICCA.

• #40 Cholangiocarcinoma – Wikipedia

  https://en.wikipedia.org/wiki/Cholangiocarcinoma

  Pemigatinib (Pemazyre) is a kinase inhibitor of fibroblast growth factor receptor 2 (FGFR2) that was approved for medical use in the United States in April 2020. […] Ivodesinib (Tibsovo) is a small molecule inhibitor of isocitrate dehydrogenase 1. […] The FDA approved ivosidenib in August 2021 for adults with previously treated, locally advanced or metastatic cholangiocarcinoma with an isocitrate dehydrogenase-1 (IDH1) mutation as detected by an FDA-approved test. […] Durvalumab, (Imfinzi) is an immune checkpoint inhibitor that blocks the PD-L1 protein on the surface of immune cells, thereby allowing the immune system to recognize and attack tumor cells. […] In Phase III clinical trials, durvalumab, in combination with standard-of-care chemotherapy, demonstrated a statistically significant and clinically meaningful improvement in overall survival and progression-free survival versus chemotherapy alone as a 1st-line treatment for patients with advanced biliary tract cancer.

• #41 Bile Duct Cancer (Cholangiocarcinoma) Treatment (PDQ®): Treatment – Health Professional Information [NCI] | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.bile-duct-cancer-cholangiocarcinoma-treatment-pdq%C2%AE-treatment-health-professional-information-nci.ncicdr0000062905

  Pending further clinical trials, cisplatin plus gemcitabine is considered the reference standard first-line chemotherapy backbone for patients with unresectable, metastatic, or recurrent bile duct cancer. […] Based on results from the TOPAZ-1 and KEYNOTE-966 trials, all patients with unresectable, metastatic, or recurrent disease should consider treatment with a checkpoint inhibitor (either durvalumab or pembrolizumab) with cisplatin and gemcitabine. […] Clinical trials of investigational therapies should be considered for patients with targetable mutations.

• #42 Clinical treatment of cholangiocarcinoma: an updated comprehensive review | Annals of Hepatology

  https://www.elsevier.es/en-revista-annals-hepatology-16-articulo-clinical-treatment-cholangiocarcinoma-an-updated-S1665268122000795

  The use of tumor vaccines in BTC is an attractive therapeutic approach as they can introduce antigens capable of activating the immune system, promoting the proliferation of memory T cells, and enhancing the immune response. […] The role of immunotherapy in the treatment of BTC is under investigation. Although immunotherapies have demonstrated limited efficacy in the unselected population, the combination of new therapeutic strategies could be the next therapeutic frontier.

• #43 Bile duct cancer immunotherapy treatment: What to expect

  https://www.medicalnewstoday.com/articles/bile-duct-cancer-immunotherapy

  Bile duct cancer, or cholangiocarcinoma, begins when cancerous cells grow and spread within the bile ducts. Some people with this cancer may benefit from a treatment known as immunotherapy. […] Historically, the most common treatments for bile duct cancer have included radiation, surgery, and chemotherapy. New research shows that immunotherapy can also help treat this form of cancer. This treatment uses an individuals immune system to fight cancer. […] Research shows that CAR-T cells can be effective in treating bile duct cancer. […] Doctors might recommend immunotherapy if other treatments do not help. They may also need immunotherapy if they are not eligible for these other treatment options. […] Research shows that immunotherapy combined with chemotherapy can be effective for bile duct cancer.

• #44 Finding the Right Targets to Treat Biliary Tract Cancers | AACR

  https://www.aacr.org/blog/2024/02/19/finding-the-right-targets-to-treat-biliary-tract-cancers/

  Among the targeted therapies examined in the study were fibroblast growth factor receptor 2 (FGFR2) inhibitors. […] To overcome this issue, researchers are exploring next-generation FGFR inhibitors. […] In September 2022, the FDA approved durvalumab (Imfinzi) in combination with gemcitabine and cisplatin for adult patients with locally advanced or metastatic BTC. […] The most recent FDA approval related to BTC came in October 2023 with an expanded indication for pembrolizumab to be used in combination with gemcitabine (Gemzar) and cisplatin for the treatment of locally advanced unresectable or metastatic BTC. […] But researchers are continuing to study ways to increase the effectiveness of PD-1 inhibitors for more patients with this cancer type, for example, by pairing them with a CTLA-4 inhibitor or a tyrosine kinase inhibitor.

• #45 Cholangiocarcinoma – Wikipedia

  https://en.wikipedia.org/wiki/Cholangiocarcinoma

  Cholangiocarcinoma is considered to be an incurable and rapidly lethal disease unless all the tumors can be fully resected (cut out surgically). […] In 2008, the Mayo Clinic reported significant success treating early bile duct cancer with liver transplantation using a protocolized approach and strict selection criteria. […] Adjuvant therapy followed by liver transplantation may have a role in treatment of certain unresectable cases. […] Locoregional therapies including transarterial chemoembolization (TACE), transarterial radioembolization (TARE) and ablation therapies have a role in intrahepatic variants of cholangiocarcinoma to provide palliation or potential cure in people who are not surgical candidates. […] If the tumor can be removed surgically, people may receive adjuvant chemotherapy or radiation therapy after the operation to improve the chances of cure.

• #46 Cholangiocarcinoma (bile duct cancer) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/cholangiocarcinoma/diagnosis-treatment/drc-20352413

  Heating cancer cells. Radiofrequency ablation uses electric current to heat and destroy cancer cells. Using an imaging test as a guide, such as ultrasound, the doctor inserts one or more thin needles into small incisions in your abdomen. When the needles reach the cancer, they’re heated with an electric current, destroying the cancer cells. […] Photodynamic therapy. In photodynamic therapy, a light-sensitive chemical is injected into a vein and accumulates in the fast-growing cancer cells. Laser light directed at the cancer causes a chemical reaction in the cancer cells, killing them. You’ll typically need multiple treatments. Photodynamic therapy can help relieve your signs and symptoms, and it may also slow cancer growth. You’ll need to avoid sun exposure after treatments. […] Biliary drainage. Biliary drainage is a procedure to restore the flow of bile. It might involve placing a thin tube into the bile duct in order to drain the bile. Other strategies include bypass surgery to reroute the bile around the cancer and stents to hold open a bile duct being collapsed by cancer. Biliary drainage helps relieve signs and symptoms of cholangiocarcinoma. […] Because cholangiocarcinoma is a very difficult type of cancer to treat, don’t hesitate to ask about your doctor’s experience with treating the condition. If you have any doubts, get a second opinion.

• #47 The new insight of treatment in Cholangiocarcinoma

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8771522/

  Radio frequency ablation (RFA) uses high-frequency alternating current to release heat energy through electrode needles, which in turn leads to local tissue necrosis. RFA has become a recognized therapy for CCA due to its efficacy, safety and availability. […] CCA is a type of tumor with high molecular diversity and genetic heterogeneity, and has a high incidence in Asia. With the increase in the incidence of CCA year by year, people’s understanding and attention to it are increasing, but the ideal treatment is still surgical treatment. For advanced patients and patients with high-risk recurrence factors, high invasiveness, positive resection margins, or LNM, radiotherapy, chemotherapy, targeted therapy, immunotherapy, TACE and other treatment methods can benefit some patients.

• #48 Treatment Options – Cholangiocarcinoma Australia

  https://cholangiocarcinomaaustralia.org/treatment-options/

  This type of surgery is performed when the tumor is too widespread to be completely removed. […] Palliative surgery is not expected to cure the cancer, but it can sometimes help someone feel better and sometimes can even help them live longer. […] Radiation therapy can also be used as a therapy for patients whose cancer has not spread widely throughout the body but is not resectable. […] Chemoradiation is a therapy for some advanced cholangiocarcinomas. […] Palliative therapy using radiation is often used to palliate (relieve) symptoms when a patients cancer is too advanced to be cured. […] Radiofrequency ablation (RFA) offers a nonsurgical, localized treatment that kills the tumor cells with heat, while sparing the healthy liver tissue. […] Chemoembolization is a minimally invasive treatment for liver cancer that can be used when there is too much tumor to treat with radiofrequency ablation (RFA).

• #49 Treatment Options – Cholangiocarcinoma Australia

  https://cholangiocarcinomaaustralia.org/treatment-options/

  Radioembolization is very similar to chemoembolization but with the use of radioactive microspheres. […] Because of the poor response to regular (systemic) chemo, doctors have tried giving the drugs directly into the hepatic artery. […] Chemotherapy may be used after surgery (often along with radiation therapy) to try to lower the risk of the cancer returning. […] Immunotherapy is treatment that helps a persons immune system better recognize and destroy cancer cells. […] Palliative therapy chemo can help shrink tumors or slow their growth for a time. […] Pain control is one of the most important aspects of cancer care. […] If your cancer has spread too far to be completely removed by surgery, doctors may focus on palliative surgery or palliative radiotherapy, as well as other palliative symptomatic therapies.

• #50 Cholangiocarcinoma Treatment & Management: Approach Considerations, Stent Placement, Photodynamic Therapy

  https://emedicine.medscape.com/article/277393-treatment

  Photodynamic therapy (PDT) is an experimental local cancer therapy already in use for other gastrointestinal malignancies. PDT is effective in restoring biliary drainage and improving quality of life in patients with nonresectable disseminated cholangiocarcinomas. […] Adjuvant and preoperative radiation therapy has been used to reduce tumors in an effort to make them resectable. This therapy has been performed with and without concurrent chemotherapy as a radiation sensitizer. […] Most often, chemotherapy is given in low doses to act as a radiation sensitizer during a 4- to 5-week course of external-beam radiotherapy. Primary chemotherapy has been evaluated as well, including gemcitabine and cisplatin as first-line chemotherapy in inoperable biliary tract carcinoma. […] Targeted agents are becoming available as second-line therapy for cholangiocarcinoma with specific driver mutations. These include fibroblast growth factor receptor 2 (FGFR2) selective tyrosine kinase inhibitors for advanced cholangiocarcinoma harboring an FGFR2 gene fusion or rearrangement, and an isocitrate dehydrogenase 1 (IDH1) inhibitor for IDH1-mutated cholangiocarcinoma.

• #51 Cholangiocarcinoma (Bile duct cancer) | Doctor

  https://patient.info/doctor/cholangiocarcinoma

  For advanced cholangiocarcinoma, endoscopic biliary stenting has become an established treatment. Evidence supports the use of metal stents over plastic to improve survival and stent patency. Other treatments such as radiofrequency ablation, transarterial chemoembolisation and radiotherapy have shown promise, and cisplatin and gemcitabine are first-line chemotherapy agents in advanced cholangiocarcinoma. […] Chemotherapy used without radiotherapy has not shown any significant local control or survival benefit. […] Photodynamic therapy is an experimental treatment which may have some benefit in terms of prolonging survival but is not currently recommended as part of routine management, given its investigational nature. […] The reality for most patients is that their long-term survival is limited and good palliative symptom-relieving care is the mainstay of management.

• #52 Bile Duct Cancer Treatment | Cholangiocarcinoma Treatment | American Cancer Society

  https://www.cancer.org/cancer/types/bile-duct-cancer/treating.html

  Its important to discuss all treatment options, including their goals and possible side effects, with your doctors to help make the decision that best fits your needs. […] Clinical trials are carefully controlled research studies that are done to get a closer look at promising new treatments or procedures. Clinical trials are one way to get state-of-the-art cancer treatment. […] You may hear about alternative or complementary methods to relieve symptoms or treat your cancer that your doctors havent mentioned. […] Be sure to talk to your cancer care team about any method you are thinking about using. […] Whether you are thinking about treatment, getting treatment, or not being treated at all, you can still get supportive care to help with pain or other symptoms. […] For some people, when treatments have been tried and are no longer controlling the cancer, it could be time to weigh the benefits and risks of continuing to try new treatments. […] Remember that even if you choose not to treat the cancer, you can still get supportive care to help with pain or other symptoms.

• #53 Bile duct cancer | Macmillan Cancer Support

  https://www.macmillan.org.uk/cancer-information-and-support/bile-duct-cancer

  Chemotherapy may be given after surgery to help reduce the risk of the cancer coming back. If surgery is not possible, you may be offered chemotherapy to shrink or slow down the growth of the cancer. […] Sometimes radiotherapy is given on its own or in combination with chemotherapy to reduce the risk of cancer coming back after surgery. It may also be used to treat symptoms caused by bile duct cancer. […] Bile duct cancer often blocks the bile ducts. This can cause jaundice (yellowing of the skin and eyes). Doctors usually treat it by putting a tube (stent) into the blocked bile duct. […] Sometimes a part of the small bowel called the duodenum can get blocked. The stomach empties into the duodenum, so if it is blocked this can cause sickness (vomiting). Putting a tube (stent) into the blockage can help. It allows food to pass through and helps with sickness. The doctor puts the stent in with a long, flexible tube that has a camera on the end (an endoscope). If a stent cannot be put in, you may be offered an operation to bypass the blockage. The surgeon connects the stomach to the next section of small bowel (the jejunum). […] You may also have treatments as part of a clinical trial.

• #54 Bile Duct Cancer | Causes, Symptoms, Treatment & Support | Guts UK

  https://gutscharity.org.uk/advice-and-information/conditions/bile-duct-cancer/

  Another recent targeted therapy that has been approved is called durvalumab. […] STENT INSERTION […] A blocked or narrowed bile duct can be helped with a stent. It is a small, thin, and expandable tube placed in the duct. This widens the duct to allow bile to flow. This treatment can treat jaundice symptoms. Doctors usually do it before chemotherapy or surgery. The stents may be a temporary or a permanent treatment. They can block with debris over time so you may be recommended to have a stent change. Whether it needs changing also depends on the type of stent used. […] HOW WILL I BE MONITORED OVER TIME? […] On diagnosis, you may meet a clinical nurse specialist (CNS). They will be your contact through treatment. […] The group of doctors, nurses, and other therapists who work together is known as the multidisciplinary team or MDT. This team will discuss the diagnosis and possible treatments for people with bile duct cancer. Your doctor or nurse will share the MDT’s decision with you. But the MDT in your local hospital may not carry out liver surgery for eCCA. The MDT then seek an opinion from a specialist liver surgical MDT in the region.

• #55 Treatment options for bile duct cancer | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/bile-duct-cancer/treatment/treatment-options

  It might be a: different combination of chemotherapy drugs, targeted cancer drug or immunotherapy. […] Which second line treatment you have depends on whether the cancer has any gene changes (mutations) or not. […] You might also have other treatments to help control your symptoms. […] Bile duct cancer can cause symptoms such as: weight loss, pain in the tummy (abdomen), yellowing of the skin and eyes – this is called jaundice. […] You usually see the symptom control team (palliative care team). They help to manage your symptoms. You might have different treatments depending on the type of symptoms you have. This might include painkillers and anti-sickness medicines. […] Some people may have radiotherapy to help control the symptoms of advanced bile duct cancer. […] Bile duct cancer can block the bile ducts and cause jaundice. Your doctor usually puts a tube called a stent in your bile duct to open it. This means the bile can flow again.

• #56 Treatment Options – Cholangiocarcinoma Australia

  https://cholangiocarcinomaaustralia.org/treatment-options/

  Radioembolization is very similar to chemoembolization but with the use of radioactive microspheres. […] Because of the poor response to regular (systemic) chemo, doctors have tried giving the drugs directly into the hepatic artery. […] Chemotherapy may be used after surgery (often along with radiation therapy) to try to lower the risk of the cancer returning. […] Immunotherapy is treatment that helps a persons immune system better recognize and destroy cancer cells. […] Palliative therapy chemo can help shrink tumors or slow their growth for a time. […] Pain control is one of the most important aspects of cancer care. […] If your cancer has spread too far to be completely removed by surgery, doctors may focus on palliative surgery or palliative radiotherapy, as well as other palliative symptomatic therapies.

• #57 Cholangiocarcinoma Treatment & Management: Approach Considerations, Stent Placement, Photodynamic Therapy

  https://emedicine.medscape.com/article/277393-treatment

  Complete surgical resection is the only therapy to afford a chance of cure for cholangiocarcinoma. Unfortunately, many patients present with unresectable disease. Additional treatment measures in cholangiocarcinoma may include the following: Stenting, Photodynamic therapy (PDT), Radiation therapy, Pharmacotherapy. […] For palliative treatment, celiac-plexus block via regional injection of alcohol or other sclerosing agent can relieve pain in the mid back from retroperitoneal tumor growth. In addition, other endoscopic forms of palliation, such as brachytherapy and radiofrequency ablation, have been used. […] Stents can be placed via endoscopic retrograde cholangiopancreatography (ERCP) or percutaneous transhepatic cholangiography (PTC) to relieve biliary obstruction. Stenting may relieve pruritus and improve quality of life.

• #58 Controlling symptoms of advanced bile duct cancer | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/bile-duct-cancer/treatment/controlling-symptoms

  Treatments for bile duct cancers include surgery, chemotherapy and treatments to control symptoms. The treatments you have depend on the stage of the cancer. […] Treatments such as cancer drugs might help to shrink or control the cancer. This can reduce the symptoms. You can also have other medicines or procedures to help relieve symptoms. These include painkillers and anti sickness medicines. And having a procedure to unblock the bile duct. This can help relieve jaundice. […] To help the bile start draining again, your doctor might put a small tube (stent) into the blocked duct. Or they might do an operation to bypass the blockage.

• #59 New Bile Duct Cancer treatments 2025 | Everyone.org

  https://everyone.org/explore/treatment/?id=76

  For patients with bile duct cancer who are not candidates for surgery or liver transplantation, chemotherapy and radiation therapy may be used to control symptoms, slow tumor growth, and improve quality of life. […] Clinical trials are ongoing to evaluate the safety and efficacy of these targeted therapies, immunotherapy approaches, and combination treatments. […] Palliative care plays a crucial role in symptom management, improving quality of life, and providing emotional and psychological support. […] In summary, surgical resection remains the only definitive treatment option with potential to cure bile duct cancer, but it is feasible only in a minority of patients diagnosed at early stages.

• #60 Bile Duct Cancer | Cholangiocarcinoma | Duke Health

  https://www.dukehealth.org/treatments/cancer/bile-duct-cancer

  Your treatment and ongoing care are discussed every week during a meeting of our cancer specialists in surgery, radiology, medical oncology, and gastroenterology. This team evaluates the status of every patient, so your personalized care plan is always updated based on your needs. If you need to see more than one doctor, we can help you coordinate your appointments so that you visit with multiple experts on one day. […] Surgery to remove cancer from your bile ducts is complex and requires a high degree of experience and expertise. Studies show that patients who undergo complex surgical procedures in major cancer centers like ours experience fewer surgical complications, shorter hospital stays, and a faster recovery. […] Our comprehensive support services range from helping patients minimize the side effects of treatment to coping with the emotional and psychological effects of diagnosis and treatment.

• #61 What is Cholangiocarcinoma (Bile Duct Cancer) and Gallbladder Cancer? | Mount Sinai – New York

  https://www.mountsinai.org/care/cancer/services/liver/cholangiocarcinoma

  If you have bile duct cancer or gallbladder cancer, you are in good hands at Mount Sinai; we have extensive experience diagnosing and treating these conditions. […] We use several types of treatments for biliary cancers. These include surgery, chemotherapy, radiation, and organ transplantation. […] Surgical procedures for cholangiocarcinoma and gallbladder cancer are complex. Intrahepatic cholangiocarcinomas and gallbladder cancers are often large and involve nearby structures. Surgery for hilar cholangiocarcinoma usually involves removing part of the liver and part of the bile duct. […] Chemotherapy plays an important role in treating cholangiocarcinoma and gallbladder cancer. You may receive chemotherapy before surgery (neoadjuvant) and/or after surgery (adjuvant). […] When cholangiocarcinoma is too advanced in the liver for us to remove it but has not spread anywhere else, we often provide radiation treatment as well, to help us control cancer growth longer. […] For these patients, we offer liver transplantation, combined with radiation and chemotherapy. Mount Sinai is one of a few centers in the United States to offer this treatment.

• #62

  https://winshipcancer.emory.edu/cancer-types-and-treatments/bile-duct-cancer/treatment.php

  Once your personalized bile duct cancer treatment plan is created, your team will discuss it with you, and treatment at Winship will be scheduled right away. Often, that means enrolling you in a clinical trial so you have access to the latest bile duct cancer treatment options. […] As Georgias only National Cancer Institute (NCI)designated Comprehensive Cancer Center, Winship researchers are pioneers in hepatobiliary oncology and lead dozens of clinical trials testing bile duct cancer treatment options each year. […] At Winship, we offer the most comprehensive array of bile duct cancer treatment options in Georgia, and the expertise to know which treatments work best for your individual cancer. Based on your unique cancer, your treatment plan may include: […] While not a treatment for bile duct cancer, most patients with extrahepatic cholangiocarcinoma (bile duct cancer outside the liver) will need to have a procedure to place a stent into the blocked bile duct to open it up before cancer treatment can begin.

• #63 What new research is being done in bile duct cancer treatment? | MD Anderson Cancer Center

  https://www.mdanderson.org/cancerwise/a-next-generation-treatment-for-bile-duct-cancer.h00-159622590.html

  For patients with cholangiocarcinoma, or bile duct cancer, the first line of treatment often includes standard cancer treatments, such as surgery, chemotherapy and radiation therapy. […] FGFR inhibitors, in combination with standard treatments, have extended the lives of many with this disease. […] Now, a new type of FGFR inhibitor may allow patients to live longer without their disease progressing. […] The drug being studied in the clinical trial, tinengotinib, is an example of a next-generation FGFR inhibitor because it binds to the FGFR2 in a unique way. […] This approach does seem to extend survival among patients, especially among those who initially responded to an FGFR inhibitor the clinical trial showed a median progression-free survival of seven months. […] Tinengotinib, on the other hand, has a unique binding mechanism away from the ATP binding pocket that enables it to target even newly resistant cancer cells.

• #64 What new research is being done in bile duct cancer treatment? | MD Anderson Cancer Center

  https://www.mdanderson.org/cancerwise/a-next-generation-treatment-for-bile-duct-cancer.h00-159622590.html

  The study showed notable clinical benefit for cholangiocarcinoma patients with acquired resistance to prior FGFR inhibitors. […] The next step is a worldwide randomized Phase III clinical trial, led by MD Anderson, which is already open for enrollment at some centers. […] We are hoping that this work will lead to subsequent approval of therapeutic options for patients who have stopped responding to the first-line treatments.

• #65 Finding the Right Targets to Treat Biliary Tract Cancers | AACR

  https://www.aacr.org/blog/2024/02/19/finding-the-right-targets-to-treat-biliary-tract-cancers/

  Biliary tract cancers (BTCs) have not always been easy to understand. […] Fortunately, that has started to change in recent years thanks to progress with molecularly targeted treatments that have led to incremental improvements in survival rates. […] The majority of BTCs are cholangiocarcinomas, which are often classified as either intrahepatic meaning the affected bile ducts are inside the liver or extrahepatic meaning the ducts are located outside the liver. […] In a study published in Scientific Reports, researchers in Europe wanted to look at whether targeted treatments that have entered clinical practice in recent years were leading to better overall survival. […] The overall survival rate for those who received targeted therapy was 22.3 months compared to 17.5 months for those who received chemotherapy, a statistically significant improvement.

• #66 Systemic therapy for advanced unresectable and metastatic cholangiocarcinoma – UpToDate

  https://www.uptodate.com/contents/systemic-therapy-for-advanced-cholangiocarcinoma

  Patients initially treated with gemcitabine plus cisplatin – FOLFOX […] Patients initially treated with gemcitabine plus cisplatin – Capecitabine plus oxaliplatin […] Patients initially treated with gemcitabine plus cisplatin – Fluoropyrimidine alone […] Patients initially treated with gemcitabine plus cisplatin – Other agents – Liposomal irinotecan […] Patients initially treated with gemcitabine plus oxaliplatin – Gemcitabine plus capecitabine […] Patients initially treated with gemcitabine plus oxaliplatin – Capecitabine plus cisplatin […] Molecularly targeted therapy – Next-generation sequencing to identify actionable molecular abnormalities […] Immunotherapy – Biomarker-selected patients […] Immunotherapy – Biomarker-unselected patients […] FGFR inhibitors for FGFR fusion-positive tumors

• #67 Bile Duct Cancer | Causes, Symptoms, Treatment & Support | Guts UK

  https://gutscharity.org.uk/advice-and-information/conditions/bile-duct-cancer/

  Chemotherapy is sometimes used before surgery to reduce the size of the cancer. This may increase the chance of completely removing the cancer. This increases the chance of survival. This is called neoadjuvant therapy. Doctors may also use chemotherapy after surgery. It reduces the risk of the cancer coming back. This treatment is called adjuvant chemotherapy. There are various types of chemotherapy for bile duct cancer. […] Newer cancer therapies treat cancer precisely. They are called targeted therapy. They are also called precision medicine. How the cancer responds to treatment may vary. It depends on the genetic type of the cancer, which varies from person to person. Recently, England, Wales, and Scotland approved a drug called pemigatinib. This treatment is for people who cannot have the tumour removed by surgery. It is either locally advanced or has spread to other parts of the body. Doctors use it when they find fibroblast growth factor receptor 2 (FGFR2) in the cancer cells. This receptor is identified by molecular testing. Pemigatinib blocks the FGFR2 receptor. This stops cancer from growing and spreading.

• #68 Finding the Right Targets to Treat Biliary Tract Cancers | AACR

  https://www.aacr.org/blog/2024/02/19/finding-the-right-targets-to-treat-biliary-tract-cancers/

  Researchers suggested the need to target BRAF mutations, which only occur in about 5% of ICC but are associated with a worse prognosis. […] Another potential therapy worth keeping an eye on is BST02, which the FDA granted Fast Track Designation in January 2024 for the treatment of all types of liver cancer, including hepatocellular carcinoma and cholangiocarcinoma.

• #69 Bile Duct Cancer Treatment for International Patients | Mass General Brigham

  https://www.massgeneralbrigham.org/en/patient-care/international/treatments-and-specialties/cancer-care/bile-duct-cancer

  In addition, our team has done pioneering work in identifying genetic mutations that may enable the use of novel therapies for this cancer type. This allows us to take a more aggressive approach to treatment (through chemotherapy, targeted therapy, immune therapy, embolization, and/or external beam radiation) before surgery. Shrinking the tumor up front often facilitates more complete removal of the tumor during the operation. […] Chemotherapy uses drugs (given intravenously or orally) to destroy cancer cells. It may be employed before or after surgery for bile duct cancer. […] Targeted therapy is a form of personalized medicine in which a drug is chosen based on the specific genetic mutation or alteration found in your own cells. It may be used before or after surgery. Some of the mutated proteins that are targeted by such therapies include IDH1, FGFR2, BRAF, and HER2.

• #70 Bile Duct Cancer | OHSU

  https://www.ohsu.edu/knight-cancer-institute/bile-duct-cancer

  The Knight Cancer Institute is a national center for clinical trials to test new ways to prevent, detect and treat cancer. […] You may be eligible for a clinical trial of a promising treatment that isn’t widely available. Bile duct clinical trials include: […] A trial studying the use of HAI and chemotherapy to treat intrahepatic bile duct cancer. […] A trial, with other leading cancer centers, to study a three-medication chemotherapy regimen to treat bile duct cancer before surgery.

• #71 Bile Duct Cancer (Cholangiocarcinoma) Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/liver/hp/bile-duct-treatment-pdq

  For patients with unresectable bile duct cancer, management is directed at palliation. […] Systemic chemotherapy is appropriate for selected patients with adequate performance status and intact organ function. […] Pending further clinical trials, cisplatin plus gemcitabine is considered the reference standard first-line chemotherapy backbone for patients with unresectable, metastatic, or recurrent bile duct cancer. […] Patients with targetable pathogenic variants can consider clinical trials of investigational therapies. Currently, targeted therapies have only been approved for patients whose disease has progressed or who are ineligible for first-line therapies. […] All patients are encouraged to enroll in clinical trials for adjuvant therapies. Information about ongoing clinical trials is available from the NCI website.

• #72

  https://ammf.org.uk/treatment-options/

  Cholangiocarcinoma is serious illness and is relatively rare. It is essential that patients are cared for by knowledgeable specialists so that they are properly assessed and offered the right treatment and management for their particular situation. […] Treatment of cholangiocarcinoma will depend on the position and size of the cancer and whether it has spread beyond the bile duct, as well as on general health. Currently, the main options are: Surgery, Chemotherapy, targeted therapy and immunotherapy, Radiotherapy (including SBRT and SIRT). […] Surgery to completely remove the cancer is currently the only potentially curative treatment for cholangiocarcinoma. This involves a major operation and, often, because the disease is too far advanced, or the patient is already too poorly, surgery is not possible. The decision about whether an operation to remove the cancer can be done depends on the results of the diagnostic tests, and on the patients general health.

• #73 Treatment options for bile duct cancer | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/bile-duct-cancer/treatment/treatment-options

  A team of doctors and other health professionals discuss the best treatment and care for you. They are called a multidisciplinary team (MDT). […] The treatment you have depends on: where in the bile ducts the cancer is, how big it is and whether it has spread (the stage), if it is near important blood vessels, if your doctor can remove the cancer completely with an operation, how well your liver works, your general health and level of fitness, if the cancer cells have any gene changes (mutations). […] Your doctor will discuss the treatment, the benefits and the possible side effects with you. […] The MDT look at your test and scan results to see if they can remove (resect) the cancer or not. The cancer can be: resectable – this means you can have an operation to try and remove it, unresectable – this means that surgery to remove the cancer is not possible.

• #74 Bile Duct Cancer | Causes, Symptoms, Treatment & Support | Guts UK

  https://gutscharity.org.uk/advice-and-information/conditions/bile-duct-cancer/

  Another recent targeted therapy that has been approved is called durvalumab. […] STENT INSERTION […] A blocked or narrowed bile duct can be helped with a stent. It is a small, thin, and expandable tube placed in the duct. This widens the duct to allow bile to flow. This treatment can treat jaundice symptoms. Doctors usually do it before chemotherapy or surgery. The stents may be a temporary or a permanent treatment. They can block with debris over time so you may be recommended to have a stent change. Whether it needs changing also depends on the type of stent used. […] HOW WILL I BE MONITORED OVER TIME? […] On diagnosis, you may meet a clinical nurse specialist (CNS). They will be your contact through treatment. […] The group of doctors, nurses, and other therapists who work together is known as the multidisciplinary team or MDT. This team will discuss the diagnosis and possible treatments for people with bile duct cancer. Your doctor or nurse will share the MDT’s decision with you. But the MDT in your local hospital may not carry out liver surgery for eCCA. The MDT then seek an opinion from a specialist liver surgical MDT in the region.

• #75 Bile Duct Cancer | Cholangiocarcinoma | Duke Health

  https://www.dukehealth.org/treatments/cancer/bile-duct-cancer

  Your treatment and ongoing care are discussed every week during a meeting of our cancer specialists in surgery, radiology, medical oncology, and gastroenterology. This team evaluates the status of every patient, so your personalized care plan is always updated based on your needs. If you need to see more than one doctor, we can help you coordinate your appointments so that you visit with multiple experts on one day. […] Surgery to remove cancer from your bile ducts is complex and requires a high degree of experience and expertise. Studies show that patients who undergo complex surgical procedures in major cancer centers like ours experience fewer surgical complications, shorter hospital stays, and a faster recovery. […] Our comprehensive support services range from helping patients minimize the side effects of treatment to coping with the emotional and psychological effects of diagnosis and treatment.

• #76 Bile Duct Cancer Treatment | Cholangiocarcinoma Treatment | American Cancer Society

  https://www.cancer.org/cancer/types/bile-duct-cancer/treating.html

  If youve been diagnosed with bile duct cancer, your treatment team will discuss your options with you. Its important to weigh the benefits of each treatment option against the possible risks and side effects. […] The main types of treatment for bile duct cancer include: Surgery for Bile Duct Cancer, Radiation Therapy for Bile Duct Cancer, Chemotherapy for Bile Duct Cancer, Targeted Drug Therapy for Bile Duct Cancer, Immunotherapy for Bile Duct Cancer, Palliative Therapy for Bile Duct Cancer. […] Your treatment options will depend on several factors: The location and extent of the cancer, Whether the cancer is resectable (removable by surgery), The likely side effects of treatment, Your overall health and personal preferences, The chances of curing the disease, extending life, or relieving symptoms.

• #77 Treatment Options – Cholangiocarcinoma Australia

  https://cholangiocarcinomaaustralia.org/treatment-options/

  After cholangiocarcinoma is found and staged, your cancer care team will discuss your treatment options with you. […] The treatment of cholangiocarcinoma depends on the size and location of the tumor, whether your cancer has spread, your overall health, anticipated side effects, and the chance of curing the disease, extending life or relieving symptoms. […] In many cases, a team of doctors including a surgical oncologist, medical oncologist, radiation oncologist, interventional radiologist, gastroenterologist and hepatologist will work with the patient to determine the best treatment plan. There are various treatment options for cholangiocarcinoma including surgery, radiation therapy, locoregional therapies, chemotherapy, targeted therapy, immunotherapy, or palliative therapy. The most sought after treatment for cholangiocarcinoma is surgery.

• #78

  https://winshipcancer.emory.edu/cancer-types-and-treatments/bile-duct-cancer/treatment.php

  Experience is crucial when it comes to bile duct cancer treatment. Winship treats more cholangiocarcinoma than any other center in Georgia. […] Experience is crucial when it comes to treating rare cancers, and Winship Cancer Institute treats more bile duct cancer than anywhere else in Georgia. We also have an unparalleled hepatobiliary oncology research program. […] In fact, research performed right here at Winship informed some bile duct cancer treatment guidelines. In other words, we offer all the latest bile duct cancer treatments plus the expertise to know when to use which therapies so you can feel confident in your care plan. […] The hepatobiliary cancer experts at Winship use the latest technology and advanced testing to analyze your bile duct cancer at every level. Your team of physicians including your surgeon, pathologist, radiation oncologist, medical oncologist and more will then meet to create a bile duct cancer treatment plan best suited to you and your disease. Well develop a plan to treat your cancer as aggressively as possible while keeping side effects to a minimum.

• #79

  https://winshipcancer.emory.edu/cancer-types-and-treatments/bile-duct-cancer/treatment.php

  About a third of patients with bile duct cancer are treated with surgery to remove the tumor. […] This bile duct cancer treatment involves the use of medication taken orally or injected to attack cancer cells throughout the body. […] Radiation therapy uses high-energy X-rays to kill cancer cells. […] Winship is the only cancer center in Georgia, and one of an elite group in the nation, to offer proton therapy. […] This type of cancer treatment uses drugs to help your bodys immune system recognize, and enhance its ability to attack, cancer cells. […] This type of drug therapy is different from chemotherapy in that it targets a cancers specific gene mutations, selectively targeting cancer cells while producing fewer side effects. […] At Winship, we are committed to delivering the most effective bile duct cancer treatment with the fewest possible side effects. […] We have a supportive oncology team of specialized doctors and nurses on staff to help you with the physical, psychological and emotional aspects of living with bile duct cancer, including symptom management and depression.

• #80 Bile Duct Cancer | OHSU

  https://www.ohsu.edu/knight-cancer-institute/bile-duct-cancer

  Some bile duct cancers respond to medications that target a gene mutation. About half of intrahepatic bile duct cancers have a mutation that can be targeted with medication. […] Immunotherapies use a range of ways to arm the body’s own immune system against cancer. Some help the body recognize and kill cancer cells, for example. The Knight Cancer Institute is a national leader in these next-generation therapies. […] A small portion of patients with intrahepatic or perihilar bile duct cancer are candidates for a liver transplant. It might help cure the cancer. […] OHSU palliative therapy experts can help patients and their families ease symptoms and stress at any stage of serious illness. […] Your care team also might offer treatments that won’t cure the cancer but that can relieve symptoms and/or extend life. These might include surgery, chemotherapy or radiation therapy. Medications can also lessen pain, nausea and itching.

• #81 Bile Duct Cancer Treatment | Cholangiocarcinoma Treatment | American Cancer Society

  https://www.cancer.org/cancer/types/bile-duct-cancer/treating.html

  Its important to discuss all treatment options, including their goals and possible side effects, with your doctors to help make the decision that best fits your needs. […] Clinical trials are carefully controlled research studies that are done to get a closer look at promising new treatments or procedures. Clinical trials are one way to get state-of-the-art cancer treatment. […] You may hear about alternative or complementary methods to relieve symptoms or treat your cancer that your doctors havent mentioned. […] Be sure to talk to your cancer care team about any method you are thinking about using. […] Whether you are thinking about treatment, getting treatment, or not being treated at all, you can still get supportive care to help with pain or other symptoms. […] For some people, when treatments have been tried and are no longer controlling the cancer, it could be time to weigh the benefits and risks of continuing to try new treatments. […] Remember that even if you choose not to treat the cancer, you can still get supportive care to help with pain or other symptoms.

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