Revolutionizing anti-HER2 therapies for extrahepatic cholangiocarcinoma and gallbladder cancer: Current advancements and future perspectives

Eur J Cancer. 2024 Mar:199:113564. doi: 10.1016/j.ejca.2024.113564. Epub 2024 Jan 20.

Abstract

Biliary tract cancers (BTCs) encompass a heterogeneous group of rare tumors, including intrahepatic cholangiocarcinoma (iCCA), extrahepatic cholangiocarcinoma (eCCA), gallbladder cancer (GBC) and ampullary cancer (AC). The present first-line palliative treatment regimen comprises gemcitabine and cisplatin in combination with immunotherapy based on two randomized controlled studies. Despite the thorough investigation of these palliative treatments, long-term survival remains low. Moving beyond conventional chemotherapies and immunotherapies, the realm of precision medicine has demonstrated remarkable efficacy in malignancies such as breast and gastric cancers, characterized by notable HER2 overexpression rates. In the context of biliary tract cancer, significant HER2 alterations are observed, particularly within eCCA and GBC, heightening the interest in precision medicine. Various anti-HER2 therapies, including trastuzumab, pertuzumab, trastuzumab-deruxtecan, zanidatamab and neratinib, have undergone investigation. The objective of this review is to summarize the current evidence and outline future directions of targeted HER2 treatment therapy in patients with biliary tract tumors, specially extrahepatic cholangiocarcinoma and gallbladder cancer.

Keywords: Extrahepatic cholangiocarcinoma; Gallbladder cancer; HER2; Targeted Therapies.

Publication types

  • Review

MeSH terms

  • Ampulla of Vater* / pathology
  • Antibodies, Bispecific*
  • Bile Duct Neoplasms* / drug therapy
  • Bile Duct Neoplasms* / pathology
  • Bile Ducts, Intrahepatic / pathology
  • Biliary Tract Neoplasms* / pathology
  • Cholangiocarcinoma* / pathology
  • Common Bile Duct Neoplasms* / pathology
  • Gallbladder Neoplasms* / drug therapy
  • Gallbladder Neoplasms* / pathology
  • Humans
  • Trastuzumab / therapeutic use

Substances

  • zanidatamab
  • Trastuzumab
  • Antibodies, Bispecific