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Review
. 2022 Jan 13;14(2):392.
doi: 10.3390/cancers14020392.

Optimizing the Diagnosis and Biomarker Testing for Patients with Intrahepatic Cholangiocarcinoma: A Multidisciplinary Approach

May T Cho  1 , Sepideh Gholami  2 , Dorina Gui  2 , Sooraj L Tejaswi  3 , Ghaneh Fananapazir  4 , Nadine Abi-Jaoudeh  1 , Zeljka Jutric  1 , Jason B Samarasena  1 , Xiaodong Li  1 , Jennifer B Valerin  1 , Jacob Mercer  5 , Farshid Dayyani  1
Affiliations
Review

Optimizing the Diagnosis and Biomarker Testing for Patients with Intrahepatic Cholangiocarcinoma: A Multidisciplinary Approach

May T Cho et al. Cancers (Basel). .

Abstract

Cholangiocarcinoma (CCA) is a heterogenous group of malignancies originating in the biliary tree, and associated with poor prognosis. Until recently, treatment options have been limited to surgical resection, liver-directed therapies, and chemotherapy. Identification of actionable genomic alterations with biomarker testing has revolutionized the treatment paradigm for these patients. However, several challenges exist to the seamless adoption of precision medicine in patients with CCA, relating to a lack of awareness of the importance of biomarker testing, hurdles in tissue acquisition, and ineffective collaboration among the multidisciplinary team (MDT). To identify gaps in standard practices and define best practices, multidisciplinary hepatobiliary teams from the University of California (UC) Davis and UC Irvine were convened; discussions of the meeting, including optimal approaches to tissue acquisition for diagnosis and biomarker testing, communication among academic and community healthcare teams, and physician education regarding biomarker testing, are summarized in this review.

Keywords: best practices; biomarker testing; challenges; cholangiocarcinoma; genomic alterations; multidisciplinary; next-generation sequencing; precision medicine.

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Conflict of interest statement

May Cho has worked as a paid consultant for QED Therapeutics, Inc.; Nadine Abi-Jaoudeh has received financial grants from Philips Medical Systems, Inc., Teclison, Inc., Sillajen, Inc., and SIRTEX and has worked as a paid consultant for Genentech Roche, QED Therapeutics, Inc., and Medtronic, Inc.; Jacob Mercer is employed by Helsinn Therapeutics (U.S.), Inc.; Farshid Dayyani has received financial grants from AZD, Bayer, BMS, Exelixis, Taiho, Trishula, Roche, Signatera, and Ipsen and has worked as a paid consultant for QED, Signatera, Genentech, FMI, Exelixis, Eisai, and AZD and has been a paid speaker for Sirtex, Signatera, Ipsen, Exelixis, Eisai, Deciphera, and Amgen; S.G., D.G., S.L.T., G.F., Z.J., J.B.S., X.L., J.B.V. have no conflicts of interest to report.

Figures

Figure 1
Figure 1
Location of cholangiocarcinoma within the biliary system and liver is reprinted from Banales JM et al. Nat Rev Gastroenterol Hepatol. 2020; 17: 557–588. Licensed under CC BY 4.0 (http://creativecommons.org/licenses/by/4.0/ Accessed on 8 November 2021).
Figure 2
Figure 2
Optimizing biomarker testing for patients with iCCA.
Figure 3
Figure 3
Communication and coordination within the multidisciplinary team in the diagnosis and treatment of iCCA.
See this image and copyright information in PMC

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