Cholangiocarcinoma is a type of cancer that occurs in the bile ducts in the liver. It is the most common primary tumor of the liver after hepatocellular carcinoma (HCC).
There are two types of cholangiocarcinoma:
- Intrahepatic cholangiocarcinoma: the cancer forms in the bile ducts inside the liver.
- Extrahepatic cholangiocarcinoma: the cancer forms in the bile ducts that carry bile outside of the liver. The cancer can form in the hilum region (common hepatic duct) and the distal region (common bile duct).
How is Cholangiocarcinoma Diagnosed?
Cholangiocarcinoma symptoms include abdominal pain, jaundice, weak stool, and discoloration in the urine. In some patients, it is discovered when using an ultrasound, tomography, and MRI, often performed for other reasons. Compared to other tumors in the liver, it is harder to distinguish from normal liver tissue.
In some cases, although the mass itself is not visible, it is diagnosed by the expansion it creates in the bile ducts. If cholangiocarcinoma is suspected in an ultrasound, tomography or MRI, the diagnosis must be confirmed by performing a needle biopsy under the guidance of an ultrasound or tomography.
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What is Unresectable, Recurrent, or Metastatic Cholangiocarcinoma?
- Unresectable cholangiocarcinoma occurs when the cancer cannot be removed by surgery.
- Recurrent cholangiocarcinoma occurs when the cancer comes back after it has been treated.
- Metastatic Cholangiocarcinoma (Stage IV) is an advanced stage of cancer and is examined in two groups:
- The first group is when the tumor has spread to the main blood vessel and lymph nodes.
- The second group is when the tumor has spread to the lymph nodes away from the tumor or has spread to other distant parts of the body.
What are Treatment Options for Cholangiocarcinoma?
One treatment option for this type of cancer is surgical intervention. In recent years, other minimally invasive treatment methods, such as percutaneous ablation and transarterial interventions, are being used for cholangiocarcinoma with successful results. Other standard treatment options include radiation therapy and chemotherapy.
Targeted therapy is a newer form of precision medicine. Targeted therapy works by targeting or interfering with the genetic alterations or biomarker that control the cancer. There are many targeted therapy drugs already approved, but research is ongoing to find more biomarkers to target. Fibroblast growth factor receptor (FGFR) pathways are especially relevant in cholangiocarcinoma and targeting these genetic alterations has become a promising treatment option.
For example, there are clinical trials studying drugs targeting FGFR2 gene rearrangements in unresectable, recurrent, or metastatic cholangiocarcinoma. Massive Bio can help you understand whether you would qualify for these or other clinical trials for cholangiocarcinoma.