As new mutational targets arise and genetic testing becomes more precise, the field of biliary tract cancer care may soon expand to accommodate a range of tailored treatments, according to Rachna Shroff, MD.

In November 2021, Shroff and colleagues published a paper in The Lancet Gastroenterology and Hepatologydetailing current and emerging therapies in advanced biliary tract cancer.1 This publication provided an important foundation for further directions in biliary tract cancer, specifically regarding the efficacy of targeted therapies developed from the heterogeneous genomic landscape of this disease. The authors highlighted promising molecular targets such as FGFR, IDH, MAPK3, MAP2K1, HER2, NTRK, and DNA mismatch repair, and shared encouraging data with potential alternatives to palliative chemotherapy in this population, including the FGFR1-3 inhibitor pemigatinib (Pemazyre), the IDH1 inhibitor ivosidenib (Tibsovo), and immunotherapies.

“This space is changing on a daily basis, and we’re getting new drugs approved quite frequently,” Shroff said. “We went from an era of having no drugs approved to now having 3 drugs approved, and we’re on the cusp of having a couple more.”

In an interview with OncLive®, Shroff discussed her recent publication in the context of additional treatments that have since emerged, the implications of the findings from the phase 3 TOPAZ-1 trial (NCT03875235), and the increasingly crucial role that biomarker testing will play when…