Journal Article

Intrahepatic cholangiocarcinoma: pathogenesis and rationale for molecular therapies

Sia, D, Tovar, V, Moeini, A, Llovet, J M

2013

Overview

Intrahepatic cholangiocarcinoma (ICC) is an aggressive malignancy with very poor prognosis. Genome-wide, high-throughput technologies have made major advances in understanding the molecular basis of this disease, although important mechanisms are still unclear. Recent data have revealed specific genetic mutations (for example, KRAS , IDH1 and IDH2 ), epigenetic silencing, aberrant signaling pathway activation (for example, interleukin (IL)-6/signal transducer and activator of transcription 3 (STAT3), tyrosine kinase receptor-related pathways) and molecular subclasses with unique alterations (for example, proliferation and inflammation subclasses). In addition, some ICCs share common genomic traits with hepatocellular carcinoma. All this information provides the basis to explore novel targeted therapies. Currently, surgery at early stage is the only effective therapy. At more advanced stages, chemotherapy regimens are emerging (that is, cisplatin plus gemcitabine), along with molecular targeted agents tested in several ongoing clinical trials. Nonetheless, a first-line conclusive treatment remains an unmet need. Similarly, there are no studies assessing tumor response related with genetic alterations. This review explores the recent advancements in the knowledge of the molecular alterations underlying ICC and the future prospects in terms of therapeutic strategies leading towards a more personalized treatment of this neoplasm.

• Publisher: Nature Publishing Group UK,Nature Publishing Group
• Subject: 631/67/1504/1610 / 692/420 / 692/699/67/395 / 692/700/565/1436/2185 / Animals / Apoptosis / Bile Duct Neoplasms / Bile Ducts, Intrahepatic / Cancer / Cancer cells / Cell Biology / Chemotherapy / Cholangiocarcinoma / Cholangiocarcinoma - drug therapy / Cholangiocarcinoma - etiology / Cholangiocarcinoma - genetics / Cholangiocarcinoma - pathology / Cisplatin / Clinical trials / Epigenetics / Gemcitabine / Gene expression / Gene mutations / Genetic aspects / Hepatocellular carcinoma / Human Genetics / Humans / Identification and classification / Internal Medicine / Kinases / Liver Neoplasms - drug therapy / Liver Neoplasms - etiology / Liver Neoplasms - genetics / Liver Neoplasms - pathology / Malignancy / Medicine / Medicine & Public Health / Molecular biology / Molecular genetics / Molecular Targeted Therapy - methods / Oncology / Pathogenesis / Protein-tyrosine kinase receptors / review / Signal Transduction / Stat3 protein / Transcription / Tumors