An Expert, Multidisciplinary Perspective on Best Practices in Biomarker Testing in Intrahepatic Cholangiocarcinoma

Author:

Madoff David C1ORCID,Abi-Jaoudeh Nadine2,Braxton David3,Goyal Lipika4,Jain Dhanpat5,Odisio Bruno C6,Salem Riad7,Schattner Mark8,Sheth Rahul6,Li Daneng9ORCID

Affiliation:

1. Yale University School of Medicine , New Haven, CT , USA

2. University of California Irvine , Orange, CA , USA

3. Hoag Memorial Hospital Presbyterian , Newport Beach, CA , USA

4. Massachusetts General Hospital , Boston, MA , USA

5. Department of Pathology, Yale University School of Medicine , New Haven, CT , USA

6. The University of Texas MD Anderson Cancer Center , Houston, TX , USA

7. Northwestern University , Chicago, IL , USA

8. Memorial Sloan Kettering Cancer Center , New York, NY , USA

9. City of Hope , Duarte, CA , USA

Abstract

Abstract Intrahepatic cholangiocarcinoma (iCCA) is a rare and aggressive malignancy that arises from the intrahepatic biliary tree and is associated with a poor prognosis. Until recently, the treatment landscape of advanced/metastatic iCCA has been limited primarily to chemotherapy. In recent years, the advent of biomarker testing has identified actionable genetic alterations in 40%-50% of patients with iCCA, heralding an era of precision medicine for these patients. Biomarker testing using next-generation sequencing (NGS) has since become increasingly relevant in iCCA; however, several challenges and gaps in standard image-guided liver biopsy and processing have been identified. These include variability in tissue acquisition relating to the imaging modality used for biopsy guidance, the biopsy method used, number of passes, needle choice, specimen preparation methods, the desmoplastic nature of the tumor, as well as the lack of communication among the multidisciplinary team. Recognizing these challenges and the lack of evidence-based guidelines for biomarker testing in iCCA, a multidisciplinary team of experts including interventional oncologists, a gastroenterologist, medical oncologists, and pathologists suggest best practices for optimizing tissue collection and biomarker testing in iCCA.

Funder

Helsinn Therapeutics (U.S.), Inc

Publisher

Oxford University Press (OUP)

Subject

Cancer Research,Oncology

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