Recent Advances in Hepatobiliary Cancers: From Diagnosis to Treatment (2nd Edition)

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: 30 June 2025 | Viewed by 4478

Special Issue Editor


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Guest Editor
Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA 02114, USA
Interests: liver cancer; biliary cancer; gallbladder cancer; immunotherapy; targeted therapy; precision medicine
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Special Issue Information

Dear Colleagues,

This Special Issue is the second edition of the Special Issue titled “Recent Advances in Hepatobiliary Cancers: From Diagnosis to Treatment”.

Hepatobiliary malignancies, including primary neoplasms of the liver (hepatocellular carcinoma [HCC] and intrahepatic cholangiocarcinoma) and those of the extrahepatic biliary system (distal cholangiocarcinoma and gallbladder carcinoma), are usually aggressive with poor prognosis and limited treatment options. The main objective for the early stage of these tumors is to cure the disease, yet recurrence is common, and most patients with hepatobiliary cancer present with unresectable or advanced disease. Tyrosine kinase inhibitors (TKIs) remain the backbone of systematic therapy for advanced HCC. However, TKIs are gradually being replaced by the combination of atezolizumab (anti-PD-L1) and bevacizumab (anti-VEGF) as first-line treatment. Due to specific challenges such as the immunosuppressive tumor microenvironment of the liver, the development of immunotherapy in hepatobiliary cancers compared to other cancers has lagged. Fortunately, there are multiple early and advanced-stage ongoing clinical trials investigating the efficacy of combination therapies which might change the landscape of HCC management for different stages in the near future. For advanced biliary tract cancers, genomic characterization has paved the way for developing targeted therapies (FGFR2, IDH1, and BRAF inhibitors) and opened the door to precision medicine. More recently, adding an immunotherapy, durvalumab (anti-PD-L1), to standard chemotherapy for biliary tract cancers has shown improvement in survival. Overall, despite evolving treatment options for hepatobiliary malignancies, there is a substantial unmet clinical need for the early detection of disease, expanding current treatment approaches, such as immunotherapy, and finding novel therapies of these debilitating tumors.

For this Special Issue of Cancers, we welcome the submission of original research and review articles that provide an overview of the most recent advances and future challenges for the diagnosis and treatment of hepatobiliary cancers.

Dr. Ilyas Sahin
Guest Editor

Manuscript Submission Information

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Keywords

  • hepatobiliary cancers
  • hepatocellular carcinoma
  • cholangiocarcinoma
  • gallbladder cancer
  • immunotherapy
  • targeted therapy
  • precision medicine

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Published Papers (2 papers)

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Review

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10 pages, 679 KiB  
Review
Radiation Segmentectomy for the Treatment of Hepatocellular Carcinoma: A Practical Review of Evidence
by Sophia N. Mourad, Cynthia De la Garza-Ramos and Beau B. Toskich
Cancers 2024, 16(3), 669; https://doi.org/10.3390/cancers16030669 - 4 Feb 2024
Cited by 2 | Viewed by 2206
Abstract
Radiation segmentectomy is a versatile, safe, and effective ablative therapy for early-stage hepatocellular carcinoma. Advances in radiation segmentectomy patient selection, procedural technique, and dosimetry have positioned this modality as a curative-intent and guideline-supported treatment for patients with solitary HCC. This review describes key [...] Read more.
Radiation segmentectomy is a versatile, safe, and effective ablative therapy for early-stage hepatocellular carcinoma. Advances in radiation segmentectomy patient selection, procedural technique, and dosimetry have positioned this modality as a curative-intent and guideline-supported treatment for patients with solitary HCC. This review describes key radiation segmentectomy concepts and summarizes the existing literary knowledgebase. Full article
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12 pages, 1691 KiB  
Systematic Review
Evaluation of Overall Survival by Restricted Mean Survival Time of Advanced Biliary Tract Cancer treated with Immunotherapy: A Systematic Review and Meta-Analysis
by Ezequiel Mauro, Marco Sanduzzi-Zamparelli, Tamara Sauri, Alexandre Soler, Gemma Iserte, Marta Fortuny and Alejandro Forner
Cancers 2024, 16(11), 2077; https://doi.org/10.3390/cancers16112077 - 30 May 2024
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Abstract
Background: For biliary tract cancer (BTC), the addition of immunotherapy (durvalumab or pembrolizumab) to gemcitabine and cisplatin (GemCis) significantly improved overall survival (OS) in phase 3 clinical trials (RCTs). However, the interpretation and magnitude of the treatment effect is challenging because OS Kaplan–Meier [...] Read more.
Background: For biliary tract cancer (BTC), the addition of immunotherapy (durvalumab or pembrolizumab) to gemcitabine and cisplatin (GemCis) significantly improved overall survival (OS) in phase 3 clinical trials (RCTs). However, the interpretation and magnitude of the treatment effect is challenging because OS Kaplan–Meier curves violate the proportional hazards (PH) assumption. Analysis using restricted mean survival time (RMST) allows quantification of the benefits in the absence of PH. This systematic review and meta-analysis aims to assess the benefit of immunotherapy-based regimens for OS at 24 months using RMST analysis. Methods: A systematic review was conducted using studies published up to 8 November 2023. Only phase 3 RCTs evaluating the use of anti-PD-1/PD-L1 combined with GemCis and reporting OS were included. KM curves for OS were digitized, and the data were reconstructed. A meta-analysis for OS by RMST at 24 months was performed. Results: A total of 1754 participants from the TOPAZ-1 and KEYNOTE-966 trials were included. In TOPAZ-1, RMSTs at 24 months were 13.52 (7.92) and 12.21 (7.22) months with GemCis plus durvalumab and GemCis alone, respectively. In KEYNOTE-966, RMSTs at 24 months were 13.60 (7.76) and 12.45 (7.73) months with GemCis plus pembrolizumab and GemCis alone, respectively. Immunotherapy-based regimens showed a mean OS difference at 24 months by an RMST of 1.21 months [(95% CI: 0.49–1.93), p < 0.001, I2 = 0%]. Conclusions: Immunotherapy-based regimens improve OS in advanced BTC. Given this magnitude of benefit, it is essential to weigh up individual patient factors, preferences, and potential risks. RMST analysis provides valuable information to patients and physicians, facilitating decision-making in a value-based medical environment. Full article
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