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Review
. 2022 Jul 28;14(15):3674.
doi: 10.3390/cancers14153674.

Precision Medicine of Hepatobiliary and Pancreatic Cancers: Focusing on Clinical Trial Outcomes

Affiliations
Review

Precision Medicine of Hepatobiliary and Pancreatic Cancers: Focusing on Clinical Trial Outcomes

Takehiko Tsumura et al. Cancers (Basel). .

Abstract

Tumor-agnostic precision medicine employing comprehensive genome profiling (CGP) and using next-generation sequencing (NGS) has been progressing recently. This review focuses on precision medicine for advanced unresectable hepatobiliary and pancreatic cancers. In this paper, for biliary tract cancer (BTC), therapies that target several regulators of cancer cell growth, including isocitrate dehydrogenase 1 (IDH1), fibroblast growth factor receptor 2 (FGFR2) fusion, proto-oncogene B-Raf (BRAF), and human epidermal growth factor receptor 2 (HER2) alterations, are reviewed. For pancreatic ductal adenocarcinoma (PDAC), therapies for Kirsten rat sarcoma virus (KRAS) gene mutation G12C, neuregulin (NRG)1, and breast cancer type 1 and 2 susceptibility (BRCA1/2), gene alterations are summarized. On the other hand, precision medicine targets were not established for hepatocellular carcinoma (HCC), although telomerase reverse transcriptase (TERT), tumor protein P53 (TP53), and Wnt/β catenin signaling alterations have been recognized as HCC driver oncogenes. Tumor-agnostic therapies for microsatellite instability-high (MSI-H) and neurotropic tyrosine receptor kinase (NTRK) fusion cancers effectively treat biliary and pancreatic cancers. Precision medicine methods developed using NGS of circulating tumor DNA (ctDNA) and utilizing a liquid biopsy technique are discussed.

Keywords: hepatobiliary cancer; liquid biopsy; next-generation sequencing; pancreatic cancer; precision medicine.

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Conflict of interest statement

The authors declare no conflict of interest.

References

    1. Javle M., Bekaii-Saab T., Jain A., Wang Y., Kelley R.K., Wang K., Kang H.C., Catenacci D., Ali S., Krishnan S., et al. Biliary Cancer: Utility of next-Generation Sequencing for Clinical Management: Genomic Profiling of Biliary Tract Cancer. Cancer. 2016;122:3838–3847. doi: 10.1002/cncr.30254. - DOI - PubMed
    1. Valle J.W., Lamarca A., Goyal L., Barriuso J., Zhu A.X. New Horizons for Precision Medicine in Biliary Tract Cancers. Cancer Discov. 2017;7:943–962. doi: 10.1158/2159-8290.CD-17-0245. - DOI - PMC - PubMed
    1. Singhi A.D., George B., Greenbowe J.R., Chung J., Suh J., Maitra A., Klempner S.J., Hendifar A., Milind J.M., Golan T., et al. Real-Time Targeted Genome Profile Analysis of Pancreatic Ductal Adenocarcinomas Identifies Genetic Alterations That Might Be Targeted with Existing Drugs or Used as Biomarkers. Gastroenterology. 2019;156:2242–2253. doi: 10.1053/j.gastro.2019.02.037. - DOI - PubMed
    1. Ang C., Klempner S.J., Ali S.M., Madison R., Ross J.S., Severson E.A., Fabrizio D., Goodman A., Kurzrock R., Suh J., et al. Prevalence of Established and Emerging Biomarkers of Immune Checkpoint Inhibitor Response in Advanced Hepatocellular Carcinoma. Oncotarget. 2019;10:4018–4025. doi: 10.18632/oncotarget.26998. - DOI - PMC - PubMed
    1. Shibata T., Arai Y., Totoki Y. Molecular Genomic Landscapes of Hepatobiliary Cancer. Cancer Sci. 2018;109:1282–1291. doi: 10.1111/cas.13582. - DOI - PMC - PubMed