Highlights from the Fourth Annual CCA Summit

Dear Readers,

We have recently concluded the 4th Annual CCA Summit, which was held on October 13-15, 2022, in Denver, Colorado. This was our largest summit thus far with 167 attendees, which brought together healthcare providers, scientists, and industry leaders. This summit was extremely successful, thanks to the efforts of the Conference Chair Rachna Shroff, MD, MS; colleagues from the Amplity Group; and several conference sponsors.

The Summit began with a session on early detection and screening of high-risk populations headlined by Steven Lin, MD, PhD, from MD Anderson Cancer Center, who described a novel exosome-based platform. Also speaking in this session was Greg Gores, MD, from Mayo Clinic, who spoke on early detection programs, and Yujin Hoshida, MD, PhD, from UT Southwestern at Dallas, who described the role of molecular biomarkers.

The conference focused on multidisciplinary management and included a session on surgical management, chaired by Flavio Rocha, MD, from Oregon Health & Science University, and Laleh Melstrom, MD, MS, from City of Hope. Surgical approaches need to be tailored to the patient and may include neoadjuvant therapy, as proposed by Shishir Maithel, MD, from Emory. Robotic resection was discussed by Hop Tran Cao, MD, from MD Anderson Cancer Center. Skye Mayo, MD, MPH, from Oregon Health & Science University, spoke in this session about hepatic arterial infusion therapy, and Maria Majella Doyle, MD, MBA, FRCS, from Washington University School of Medicine, St Louis, presented on liver transplant.

We are looking forward to novel agents and new approvals from the US Food and Drug Administration in cholangiocarcinoma (CCA). Promising therapies include new IDH1, PARP, and Her2/neu-pathway–directed agents, as discussed by Angela Lamarca, MD, PhD, MSc (Fundación Jiménez Díaz University); Vaibhav Sahai, MBBS, MS (University of Michigan Health); and Gentry King, MD (Fred Hutch Cancer Center). Other pathways that are currently being targeted in clinical trials include KRAS, MDM2, MTAP loss, and vascular endothelial growth factor/Delta-like 4. Jennifer Knox, MSc, MD, from Princess Margaret Hospital in Toronto, headlined an insightful discussion on therapy integration, sequencing, and toxicity, which included presentations from Sunyoung Lee, MD, PhD, from MD Anderson Cancer Center, and Daniel Ahn, DO, from Mayo Clinic.

A new feature incorporated in this meeting was the “cross-fire” medical debates: the role of immunotherapy in CCA was explored in a lively discussion with Teresa Macarulla, MD, PhD, from Vall d’Hebron University Hospital in Barcelona, and Mark Yarchoan, MD, from Johns Hopkins. This was followed by a debate on the role of yttrium-90 in the initial management of CCA. These debates were popular and attracted robust audience participation.

Toxicity of novel agents, including recently approved tyrosine kinase inhibitors and immunotherapy, can be limiting. Aung Naing, MD, from MD Anderson Cancer Center, and his team provided practical guidelines, including web-based portals that can guide management. Nipun Merchant, MD, of the University of Miami Health System, presented on managing postoperative complications and the importance of a multidisciplinary approach at high-volume centers.

The conference concluded with an instructive discussion led by Ardaman Shergill, MD, from University of Chicago Medicine, on supportive care and management of complications of biliary tract cancer. We were excited to see a strong participation from fellows and trainees, with a productive poster session led by Midhun Malla, MD, MS, from West Virginia University. Finally, kudos to Emily Hemmer, BSN-RN, and her nominating physician colleague, Ryan Fields, MD, of the Washington University School of Medicine, St. Louis, for the ONE (Oncology Nurses of Excellence) Award. We are grateful for all that you do for your patients!

Sincerely,

Milind M. Javle, MD