Reference Detail

Ref Type

Journal Article

PMID

(39232586)

Authors

Chen LT, Vogel A, Hsu C, Chen MH, Fang W, Pangarsa EA, Sharma A, Ikeda M, Park JO, Tan CK, Regala E, Tai D, Tanasanvimon S, Charoentum C, Chee CE, Lui A, Sow J, Oh DY, Ueno M, Ramaswamy A, Jeo WS, Zhou J, Curigliano G, Yoshino T, Bai LY, Pentheroudakis G, Chiang NJ, Cervantes A, Chen JS, Ducreux M

Title

Pan-Asian adapted ESMO Clinical Practice Guidelines for the diagnosis, treatment and follow-up of patients with biliary tract cancer.

Journal	Vol	Issue	Date	Pages	Journal Short Title
ESMO open	9	8	2024 Aug	103647	ESMO Open

URL

Abstract Text

The European Society for Medical Oncology (ESMO) Clinical Practice Guidelines for the diagnosis, treatment and follow-up of patients with biliary tract cancer (BTC), published in late 2022 were adapted in December 2023, according to established standard methodology, to produce the Pan-Asian adapted (PAGA) ESMO consensus guidelines for the management of Asian patients with BTC. The adapted guidelines presented in this manuscript represent the consensus opinions reached by a panel of Asian experts in the treatment of patients with BTC representing the oncological societies of China (CSCO), Indonesia (ISHMO), India (ISMPO), Japan (JSMO), Korea (KSMO), Malaysia (MOS), the Philippines (PSMO), Singapore (SSO), Taiwan (TOS) and Thailand (TSCO), co-ordinated by ESMO and the Taiwan Oncology Society (TOS). The voting was based on scientific evidence and was independent of the current treatment practices, drug access restrictions and reimbursement decisions in the different regions of Asia. Drug access and reimbursement in the different regions of Asia are discussed separately in the manuscript. The aim is to provide guidance for the optimisation and harmonisation of the management of patients with BTC across the different countries and regions of Asia, drawing on the evidence provided by both Western and Asian trials, whilst respecting the differences in screening practices and molecular profiling, as well as age and stage at presentation. Attention is drawn to the disparity in the drug approvals and reimbursement strategies, between the different countries.

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Molecular Profile	Treatment Approach

Gene Name	Source	Synonyms	Protein Domains	Gene Description	Gene Role

Therapy Name	Drugs	Efficacy Evidence	Clinical Trials

Drug Name	Trade Name	Synonyms	Drug Classes	Drug Description

Gene	Variant	Impact	Protein Effect	Variant Description	Associated with drug Resistance

Molecular Profile	Indication/Tumor Type	Response Type	Therapy Name	Approval Status	Evidence Type	Efficacy Evidence	References
RET fusion	biliary tract cancer	sensitive	Selpercatinib	Guideline	Actionable	Retevmo (selpercatinib) is included in the Pan-Asian Guidelines Adaptation (PAGA) for biliary tract cancer patients harboring RET fusions who have progressed on or are intolerant of prior therapies (PMID: 39232586; ESMO.org).	detail... 39232586
MSH6 negative	biliary tract cancer	sensitive	Pembrolizumab	Guideline	Actionable	Keytruda (pembrolizumab) is included in the Pan-Asian Guidelines Adaptation (PAGA) for patients with mismatch repair-deficient (dMMR, defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) biliary tract cancer who have progressed on or are intolerant of non-immune checkpoint inhibitor therapies (PMID: 39232586; ESMO.org).	detail... 39232586
MLH1 negative	biliary tract cancer	sensitive	Pembrolizumab	Guideline	Actionable	Keytruda (pembrolizumab) is included in the Pan-Asian Guidelines Adaptation (PAGA) for patients with mismatch repair-deficient (dMMR, defined by the loss of MLH1, PMS2, MSH2, or MSH6 expression by IHC) biliary tract cancer who have progressed on or are intolerant of non-immune checkpoint inhibitor therapies (PMID: 39232586; ESMO.org).	detail... 39232586
IDH1 mutant	cholangiocarcinoma	sensitive	Ivosidenib	Guideline	Actionable	Tibsovo (ivosidenib) is included in the Pan-Asian Guidelines Adaptation (PAGA) for cholangiocarcinoma patients harboring IDH1 mutations who have progressed after one or more lines of systemic therapy (PMID: 39232586; ESMO.org).	detail... 39232586
BRAF V600E	biliary tract cancer	sensitive	Dabrafenib + Trametinib	Guideline	Actionable	Tafinlar (dabrafenib) in combination with Mekinist (trametinib) is included in the Pan-Asian Guidelines Adaptation (PAGA) for biliary tract cancer patients harboring BRAF V600E who have progressed on one or more lines of systemic therapy (PMID: 39232586; ESMO.org).	39232586 detail...
FGFR2 fusion	biliary tract cancer	sensitive	Futibatinib	Guideline	Actionable	Lytgobi (futibatinib) is included in the Pan-Asian Guidelines Adaptation (PAGA) for biliary tract cancer patients harboring FGFR2 fusions who have progressed after one or more lines of systemic therapy (PMID: 39232586; ESMO.org).	detail... 39232586
FGFR2 fusion	biliary tract cancer	sensitive	Pemigatinib	Guideline	Actionable	Pemazyre (pemigatinib) is included in the Pan-Asian Guidelines Adaptation (PAGA) for biliary tract cancer patients harboring FGFR2 fusions who have progressed after one or more lines of systemic therapy (PMID: 39232586; ESMO.org).	detail... 39232586