Background:Biliary tract cancers (BTCs) are aggressive in nature, often presenting asymptomatically until they are diagnosed at an advanced stage. Surgical resection or liver transplantation are potential curative options. However, a large proportion of patients present with incurable locally advanced or metastatic disease and most of these patients are only eligible for palliative chemotherapy or best supportive care. More recently, targeted therapies have proven beneficial in a molecularly selected subgroup of patients with cholangiocarcinoma who have progressed on previous lines of systemic treatment. However, only a minority of patients with BTCs whose tumours harbour specific molecular alterations can access these therapies.Methods:In relation to ADCs, studies regarding use of antibody–drug conjugates in cancer, particularly in BTCs, were searched in Embase (1974 to 2024) and Ovid MEDLINE(R) (1946 to 2024) to obtain relevant articles. Examples of current clinical trials utilising ADC treatment in BTCs were extracted from the ClinicalTrials.gov trial registry.Conclusions:Overall, this review has highlighted that ADCs have shown encouraging outcomes in cancer therapy, and this should lead to further research including in BTCs, where treatment options are often limited. The promising results observed with ADCs in various cancers underscore their potential as a transformative approach in oncology, warranting continued exploration and development and the need for education on the management of their specific toxicities. By addressing current challenges and optimising ADC design and application, future studies could potentially improve treatment outcomes for patients with BTCs and beyond, potentially in both early and advanced stage settings.
背景：胆道癌（BTCs）具有侵袭性，通常在无症状状态下进展，直至晚期才被诊断。手术切除或肝移植是潜在的根治性选择。然而，大部分患者就诊时已处于无法根治的局部晚期或转移性疾病阶段，其中多数患者仅适合接受姑息性化疗或最佳支持治疗。近年来，靶向治疗已被证明对经过前期系统治疗后进展的、具有特定分子特征的胆管癌患者亚群有益。然而，仅少数携带特定分子改变的BTCs患者能够获得这些治疗。 方法：关于抗体药物偶联物（ADCs）在癌症特别是BTCs中的应用研究，通过检索Embase（1974年至2024年）和Ovid MEDLINE(R)（1946年至2024年）数据库获取相关文献。当前在BTCs中应用ADC治疗的临床试验案例提取自ClinicalTrials.gov试验注册平台。 结论：总体而言，本综述强调ADCs在癌症治疗中已显示出令人鼓舞的疗效，这应推动包括BTCs在内的进一步研究，因为该疾病治疗选择通常有限。ADCs在多种癌症中观察到的良好结果，凸显了其作为肿瘤学领域变革性治疗方法的潜力，值得持续探索和发展，并需要加强对其特定毒性管理的教育。通过应对当前挑战并优化ADC的设计与应用，未来研究有望改善BTCs及其他癌症患者的治疗结局，可能同时适用于早期和晚期阶段。
Antibody-Drug Conjugates and Their Potential in the Treatment of Patients with Biliary Tract Cancer
肿瘤(癌症)患者之家