Biliary tract cancers (BTC) are a heterogeneous group of cancers that continue to present a particularly poor prognosis. Treatment of BTC is rapidly evolving but faces many challenges to improving patient outcomes and maximising benefit from treatment. Only a minority of patients are diagnosed with early-stage disease, and are suitable for curative resection. Current surgical strategies are limited by a high relapse rate and despite extensive efforts focused on adjuvant strategies, development of more effective adjuvant strategies remains a challenge. In addition, the role of locoregional strategies, liver transplant and neoadjuvant treatment remains unclear. Systemic treatment in the advanced setting is based on three main pillars. First, cytotoxic chemotherapy options, second, the addition of immunotherapy to chemotherapy and third, targeted therapies. The role of targeted therapies is oriented by many promising targets including IDH1 mutations, FGFR2 fusions, BRAF-V600E mutations, and HER2 amplifications. The aim of this review is to provide an overview of current facts and future hopes in the management of BTC, including an overview of the unmet need, and a particular focus on systemic therapies.

中文翻译：

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胆道癌全身治疗的事实和希望


胆道癌 (BTC) 是一组异质性癌症，预后特别差。 BTC 的治疗正在迅速发展，但在改善患者治疗效果和最大限度地提高治疗效益方面面临许多挑战。只有少数患者被诊断为早期疾病，适合根治性切除。目前的手术策略受到高复发率的限制，尽管在辅助策略上做出了大量努力，但开发更有效的辅助策略仍然是一个挑战。此外，局部策略、肝移植和新辅助治疗的作用仍不清楚。晚期环境中的系统治疗基于三个主要支柱。第一，细胞毒性化疗选择，第二，化疗中添加免疫疗法，第三，靶向治疗。靶向治疗的作用是由许多有前景的靶点决定的，包括 IDH1 突变、FGFR2 融合、BRAF-V600E 突变和 HER2 扩增。本次综述的目的是概述 BTC 管理的当前事实和未来希望，包括概述未满足的需求，并特别关注全身治疗。