Dear Readers,
The 2025 ASCO Gastrointestinal Cancers Symposium featured exciting updates in biliary tract cancer (BTC) research. The natural history of mutational subsets in BTC is of critical importance, and recent real-world studies presented at the symposium highlighted this as well. A collaborative study led by Dr Choong-kun Lee from Yonsei University in Korea and Dr Sunyoung Lee from MD Anderson Cancer Center investigated HER2-positive BTC and demonstrated a poorer prognosis and outcome with first-line chemotherapy but highlighted the benefits of HER2-targeted therapy in this population. Dr Renuka Iyer, et al, from Roswell Park Cancer Center investigated the Flatiron Health-Foundation Medicine database for the natural history of MDM2-amplified, TP53 wild-type BTC and noted that MDM2 amplification does not significantly impact prognosis. Dr Richard Kim and colleagues from Moffitt Cancer Institute used billing/claims data and showed that adding immunotherapy to FGFR2/IDH1-altered cholangiocarcinoma did not improve prognosis over chemotherapy alone.
On the treatment front, zanidatamab’s optimal dose was identified as 20 mg/kg every 2 weeks for HER2-positive BTC. Dr Christos Fountzilas, et al, from Roswell Park Cancer Center presented data on tinengotinib, on FGFR-altered cholangiocarcinoma, with acquired kinase-domain mutations. These data have led to a phase 3, randomized clinical trial in this population (FIRST-308). These findings emphasize the growing role of personalized medicine and multidisciplinary therapies in improving BTC outcomes.
Sincerely,
Milind M. Javle, MD
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