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CANCER:

Cholangiocarcinoma

Related cancers:
1d
Prognostic impact of concomitant genomic alterations in patients affected by FGFR2-positive locally advanced unresectable or metastatic cholangiocarcinoma treated with pemigatinib as second or further line of systemic treatment: molecular analysis of the real-world Italian PEMIREAL and French PEMIBIL cohort studies (AIOM 2024)
Our results seem to confirm the negative prognostic role in terms of PFS of GA in BAP1 and CDKN2A genes in patients affected by locally advanced or metastatic FGFR2-positive CCA treated with pemigatinib in a real-world setting.
Clinical • Real-world evidence • Real-world • Metastases
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TP53 (Tumor protein P53) • FGFR2 (Fibroblast growth factor receptor 2) • PTEN (Phosphatase and tensin homolog) • IDH1 (Isocitrate dehydrogenase (NADP(+)) 1) • CDKN2A (Cyclin Dependent Kinase Inhibitor 2A) • BAP1 (BRCA1 Associated Protein 1) • CDKN2B (Cyclin Dependent Kinase Inhibitor 2B)
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FGFR2 fusion • CDKN2A mutation
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FoundationOne® CDx
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Pemazyre (pemigatinib)
1d
Advanced Intrahepatic Cholangiocarcinoma (iCCA): Investigating Co-Molecular Alterations (AIOM 2024)
The FGFR and IDH-1 pathways are the primary targets for therapy, with FGFR-2 and IDH-1 inhibitors, such as Pemigatinib and Ivosidenib respectively, already available on the market. This prospective study validates the prevalence of mutations documented in the literature and underscores the significance of NGS in presenting supplementary therapeutic avenues. Moreover, we demonstrated the role of other potential targets co-expressed with FGFR2 or IDH1 which could represent a crucial opportunity for novel combinations or sequences therapies.
BRCA Biomarker • Metastases
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HER-2 (Human epidermal growth factor receptor 2) • KRAS (KRAS proto-oncogene GTPase) • BRAF (B-raf proto-oncogene) • TP53 (Tumor protein P53) • BRCA2 (Breast cancer 2, early onset) • FGFR2 (Fibroblast growth factor receptor 2) • IDH1 (Isocitrate dehydrogenase (NADP(+)) 1) • NTRK1 (Neurotrophic tyrosine kinase, receptor, type 1) • CDKN2A (Cyclin Dependent Kinase Inhibitor 2A) • ARID1A (AT-rich interaction domain 1A) • MTAP (Methylthioadenosine Phosphorylase) • BAP1 (BRCA1 Associated Protein 1) • CDKN2B (Cyclin Dependent Kinase Inhibitor 2B) • NTRK (Neurotrophic receptor tyrosine kinase) • CA 19-9 (Cancer antigen 19-9)
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TP53 mutation • KRAS mutation • IDH1 mutation • FGFR2 mutation • FGFR2 fusion • CDKN2A mutation • BAP1 mutation • FGFR2 expression • FGFR2b expression
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FoundationOne® CDx
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Pemazyre (pemigatinib) • Tibsovo (ivosidenib)
1d
First results from the Italian cholangiocarcinoma dataset (ANITA): extended molecular profiling (EMP), access to targeted treatment (TT) and clinical characterization of FGFR2- rearranged and IDH1-mutated advanced biliary tract cancers (BTC) (AIOM 2024)
Among pts with EMP available, 64.2% had intrahepatic cholangiocarcinoma and 69.8% received CT1 (36.1% cisplatinum-gemcitabine). Despite a broader availability of EMP in advanced BTC in recent years, access to TT remains suboptimal even in referral Institutions. Our results demonstrate TT administration as a pivotal positive prognostic factor in a real-world setting, whilst FGFR2 or IDH1 alterations did not act as prognostic determinants per-se. Therefore, strategies aiming at improving the rate of patients receiving TT are warranted.
Clinical • Metastases
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FGFR2 (Fibroblast growth factor receptor 2) • IDH1 (Isocitrate dehydrogenase (NADP(+)) 1)
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IDH1 mutation • FGFR2 mutation • FGFR2 fusion • IDH1 R132
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FoundationOne® CDx
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cisplatin • gemcitabine
1d
Hepatic methotrexate-associated lymphoproliferative disease: a case report and literature review. (PubMed, Surg Case Rep)
MTX-LPD can occur in the liver. Clinician should suspect hepatic MTX-LPD when a liver mass is detected in patient who had been treating with MTX for RA.
Review • Journal
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CD20 (Membrane Spanning 4-Domains A1)
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CD20 positive
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methotrexate
2d
FGFR2 fusions assessed by NGS, FISH, and immunohistochemistry in intrahepatic cholangiocarcinoma. (PubMed, J Gastroenterol)
FGFR2 fusion should be assessed for advanced iCCA patients. We recommend DNA + RNA-based NGS as the preferred option to supply all possible therapeutic targets. FISH should be preferred if the tumor sample is insufficient for NGS or if the patient is inclined to receive FGFR inhibitors promptly. Although IHC is not the preferred method to identify FGFR2 fusion, it might be used as preliminary screening for FGFR2 alterations if the hospital cannot offer NGS or FISH, and the results need to be validated before FGFR2 inhibitors treatment.
Journal • Next-generation sequencing
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PD-L1 (Programmed death ligand 1) • FGFR2 (Fibroblast growth factor receptor 2)
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FGFR2 fusion
2d
The PKHD1 gene inhibits tumor proliferation and invasion in intrahepatic cholangiocarcinoma by activating the Notch pathway. (PubMed, Int J Med Sci)
Moreover, tumor proliferation, migration, and invasion were promoted in loss-of-function experiments in vitro and in vivo, which was partially reversed by DAPT. PKHD1 inhibits the proliferation, migration, and invasion of ICC, and the Notch pathway may be the downstream mechanism of the negative regulatory effect of PKHD1 during the progression of ICC.
Journal
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NOTCH1 (Notch 1) • PKHD1 (PKHD1 Ciliary IPT Domain Containing Fibrocystin/Polyductin)
2d
Therapy-relevant MDM2 amplification in cholangiocarcinomas in Caucasian patients. (PubMed, Ther Adv Med Oncol)
Real-world evidence in our Caucasian patient population confirmed that a significant number of intrahepatic CCAs showcase MDM2 amplification, qualifying for a personalized therapy option with Brigimadlin. MDM2 amplification must therefore be considered in the context of personalized molecular testing in CCA.
Journal
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FGFR2 (Fibroblast growth factor receptor 2) • MDM2 (E3 ubiquitin protein ligase)
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TP53 wild-type • MDM2 amplification
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brigimadlin (BI 907828)
3d
In Silico Design of Novel EpCAM-Binding Aptamers for Targeted Delivery of RNA Therapeutics. (PubMed, Nanomaterials (Basel))
PLD01-functionalized nanovesicles enabled EpCAM-targeted delivery of the therapeutic cargo to CCA cells. In summary, these EpCAM-targeting aptamers can be utilized to direct the delivery of theranostic agents to EpCAM-expressing cells.
Journal
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EPCAM (Epithelial cell adhesion molecule)
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EPCAM expression
3d
Optimizing outcomes and personalizing care with targeted agents in advanced cholangiocarcinoma. (PubMed, Cancer Treat Rev)
We also discuss the challenges and opportunities originating from recent clinical trials evaluating targeted treatments and our own institutional experience at UCLH that have aimed to address some of these biological complexities and have translated into improved patient outcomes via effective molecularly driven patient selection strategies. We also provide perspectives on emerging novel, next generation targeted inhibitors overcoming treatment resistance to previous targeted agents with demonstrated clinical value in a challenging patient population.
Review • Journal • Metastases
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HER-2 (Human epidermal growth factor receptor 2) • IDH1 (Isocitrate dehydrogenase (NADP(+)) 1) • NTRK (Neurotrophic receptor tyrosine kinase)
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BRAF V600E • BRAF V600
3d
Neoadjuvant Pemigatinib as a Bridge to Living Donor Liver Transplantation for Intrahepatic Cholangiocarcinoma with FGFR2 Rearrangement. (PubMed, Am J Transplant)
He underwent an uncomplicated LDLT (including an uncomplicated donor surgery) and at one year follow-up is without evidence of disease recurrence. We believe this is the first report of LDLT for this indication.
Journal
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FGFR2 (Fibroblast growth factor receptor 2)
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FGFR2 rearrangement
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Pemazyre (pemigatinib)
3d
High Expression of the Tumor Suppressor Protein ITIH5 in Cholangiocarcinomas Correlates with a Favorable Prognosis. (PubMed, Cancers (Basel))
Our results suggest that the upregulation of ITIH5 is particularly abundant in intrahepatic CCAs (iCCA). The mechanisms mediating the strong initial upregulation of ITIH5 during the oncogenic transformation of bile duct cells are still unclear.
Journal
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ITIH5 (Inter-Alpha-Trypsin Inhibitor Heavy Chain 5)
3d
Testing the Combination of New Anti-cancer Drug Peposertib With Avelumab and Radiation Therapy for Advanced/Metastatic Solid Tumors and Hepatobiliary Malignancies (clinicaltrials.gov)
P1/2, N=101, Recruiting, National Cancer Institute (NCI) | Trial completion date: Dec 2024 --> Dec 2025 | Trial primary completion date: Dec 2024 --> Dec 2025
Trial completion date • Trial primary completion date • Combination therapy • Tumor mutational burden • IO biomarker • Metastases
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TMB (Tumor Mutational Burden)
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Bavencio (avelumab) • peposertib (M3814)
3d
Trial completion
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HER-2 (Human epidermal growth factor receptor 2) • PD-L1 (Programmed death ligand 1) • ER (Estrogen receptor) • PGR (Progesterone receptor)
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Keytruda (pembrolizumab) • Lenvima (lenvatinib)
3d
Head-to-head study of [18F]FAPI-04 PET/CT and [18F]FDG PET/CT for non-invasive assessment of liver cancer and its immunohistochemical markers. (PubMed, BMC Cancer)
[18F]FAPI-04 exhibits superior performance over [18F]FDG in PET/CT evaluation of liver cancer, characterized by increased sensitivity and SUVmax/TBR. Significant correlations with molecular markers, including Ki67, suggest [18F]FAPI-04's potential for characterizing liver cancer subtypes and assessing tumor proliferation. However, further research is required to validate these findings and their clinical significance.
Clinical • Journal • Head-to-Head • FDG PET
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CD34 (CD34 molecule)
3d
Genetic, Epigenetic, and Microenvironmental Drivers of Cholangiocarcinoma. (PubMed, Am J Pathol)
This review explores the multifaceted genetic, epigenetic and microenvironmental drivers of CCA. Understanding these diverse mechanisms is essential for characterizing the complex pathways of CCA carcinogenesis and developing targeted therapies to improve patient outcomes.
Review • Journal
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FGFR2 (Fibroblast growth factor receptor 2) • IDH1 (Isocitrate dehydrogenase (NADP(+)) 1) • IDH2 (Isocitrate Dehydrogenase (NADP(+)) 2) • ARID1A (AT-rich interaction domain 1A) • BAP1 (BRCA1 Associated Protein 1)
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IDH1 mutation • ARID1A mutation • FGFR2 mutation • BAP1 mutation
4d
Phenotypic and transcriptomic profiling of induced pluripotent stem cell (iPSC)-derived NK cells and their cytotoxicity against cancers. (PubMed, Stem Cell Res Ther)
This study highlights the potential of iPSCs as an effective alternative cell source for generating NK cells. Using a two-step in vitro monolayer feeder-free system, we successfully generated iNK cells that not only expressed key NK cell markers and their receptors but also displayed a transcriptomic profile closely resembling PB-NK cells. Furthermore, iNK cells exhibited cytotoxicity against CCA and BCA cell lines comparable to that of PB-NK cells. This approach could pave the way for off-the-shelf NK cell products, potentially enhancing the effectiveness of adoptive NK cell therapy.
Journal • IO biomarker
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PTPRC (Protein Tyrosine Phosphatase Receptor Type C) • NCAM1 (Neural cell adhesion molecule 1)
5d
Rapid Determination of IDH1 and IDH2 Mutation Status in AML and Glioma Using a Microfluidic Detection System (AMP 2024)
Determination of IDH1-2 mutation status is important for a variety of malignancies for diagnostics, classification, prognosis, and therapy selection. The Idylla system is easy to use and requires little training; therefore, it is the ideal assay to implement in a variety of labs. Overall, the Idylla platform provides quick, dependable, and easy-to-use technology for performing this analysis.
KIT (KIT proto-oncogene, receptor tyrosine kinase) • IDH1 (Isocitrate dehydrogenase (NADP(+)) 1) • IDH2 (Isocitrate Dehydrogenase (NADP(+)) 2)
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IDH1 mutation • IDH2 mutation • KIT mutation
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Idylla™ IDH1-2 Mutation Assay
5d
Analytical Validation of the Promega Long Mononucleotide Repeat Microsatellite Instability Assay (AMP 2024)
Via the analysis of longer homopolymer repeat regions, the Promega LMR MSI assay demonstrates enhanced sensitivity for subtle phenotypes. This assay may be better suited than other PCR- and CE-based approaches for certain disease types.
Microsatellite instability • MSi-H Biomarker • IO biomarker
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MSI (Microsatellite instability)
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MSI-H/dMMR
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Idylla™ MSI Test
5d
SGNB7H4V-001: A Study of SGN-B7H4V in Advanced Solid Tumors (clinicaltrials.gov)
P1, N=572, Recruiting, Seagen Inc. | N=430 --> 572 | Trial completion date: Jan 2027 --> Nov 2027 | Trial primary completion date: Jun 2025 --> Nov 2027
Enrollment change • Trial completion date • Trial primary completion date
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HER-2 (Human epidermal growth factor receptor 2)
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HR positive • HER-2 negative • PTEN mutation + HR positive
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Keytruda (pembrolizumab) • felmetatug vedotin (PF-08046048)
6d
ESR-22-21719: Neoadjuvant Tremelimumab and Durvalumab With Gem/Cis in Intrahepatic Cholangiocarcinoma (clinicaltrials.gov)
P2, N=0, Withdrawn, Georgetown University | N=28 --> 0 | Recruiting --> Withdrawn
Enrollment change • Trial withdrawal
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cisplatin • Imfinzi (durvalumab) • gemcitabine • Imjudo (tremelimumab)
8d
Correlation between perioperative fluid therapy and surgical prognosis of gastrointestinal malignancies (ChiCTR2400090619)
P=N/A, N=10000, Not yet recruiting, The First Affiliated Hospital of Air Force Military Medical University; The First Affiliated Hospital of the Air Force Military Medical University
New trial
8d
PET/CT imaging of Gallium-68 labeled FAP probes in patients with solid tumors (ChiCTR2400089998)
P=N/A, N=0, Recruiting, Affiliated Hospital of North Sichuan Medical College; Affiliated Hospital of North Sichuan Medical College
New trial
8d
A single-center, open-label, prospective clinical study of 3D 4K fluorescence laparoscopy in hepatobiliary surgery (ChiCTR2400089206)
P=N/A, N=60, Not yet recruiting, Fifth Affiliated Hospital, Sun Yat-Sen University; Fifth Affiliated Hospital, Sun Yat-Sen University
New trial • Surgery
8d
Phase II study of Sintilimab combined with GS regimen for neoadjuvant treatment of locally advanced biliary tract cancer (BTC) (ChiCTR2400089592)
P2, N=38, Not yet recruiting, Shanghai Eastern Hepatobiliary Surgery Hospital; Shanghai Eastern Hepatobiliary Surgery Hospital
New P2 trial • Metastases
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Tyvyt (sintilimab)
8d
New P2 trial • Metastases
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5-fluorouracil • Lenvima (lenvatinib) • leucovorin calcium • Ariely (adebrelimab)
8d
A Phase 1/2 Study to Evaluate the Safety and Efficacy of MK-2870 Monotherapy or in Combination With Other Anticancer Agents in Gastrointestinal Cancers (ChiCTR2400089007)
P2, N=130, Not yet recruiting, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology; Union Hospital, Tongji Medical College, Huazhong University of
New P2 trial • Combination therapy
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MSI (Microsatellite instability) • MLH1 (MutL homolog 1) • MSH6 (MutS homolog 6) • MSH2 (MutS Homolog 2) • BRCA (Breast cancer early onset) • CD4 (CD4 Molecule)
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MSI-H/dMMR • BRCA mutation • MSH6 expression
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FoundationOne® CDx
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5-fluorouracil • sacituzumab tirumotecan (MK-2870)
8d
New P2 trial • Metastases
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cisplatin • gemcitabine • Kaitanni (cadonilimab)
8d
New P2 trial • Metastases
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5-fluorouracil • oxaliplatin • leucovorin calcium • Onivyde (nanoliposomal irinotecan) • Ariely (adebrelimab)
14d
Tepotinib in Cholangiocarcinoma with MET Amplification: A Case Report. (PubMed, Onco Targets Ther)
Systemic therapy, such as chemotherapy using gemcitabine and cisplatin, is the first choice for patients with cholangiocarcinoma who were inoperable. The development of precision medicine has expanded the paradigm of targeted therapies to increasingly favorable options in the second line and beyond, and prolong overall survival. Detecting druggable mutations (mutations potentially amenable to treatment with) for identifying a landscape of therapeutic options is imperative for managing cholangiocarcinoma.
Journal
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MET (MET proto-oncogene, receptor tyrosine kinase)
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MET amplification
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cisplatin • gemcitabine • Tepmetko (tepotinib)
14d
Hepatic squamous cell carcinoma initially presenting as cholecystitis misdiagnosed as cholangiocarcinoma: A case report. (PubMed, Oncol Lett)
It is hypothesized that fluctuations in carcinoembryonic antigen levels during laboratory tests can significantly aid the diagnosis, treatment and prognosis of tumors. Furthermore, imaging studies are essential for the early diagnosis of PSCCL and the exclusion of metastatic squamous cell carcinoma.
Journal
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CEACAM5 (CEA Cell Adhesion Molecule 5)
14d
A Study to Determine Whether Chemotherapy and Atezolizumab is Better Than Chemotherapy, Bevacizumab and Atezolizumab in Patients With Advanced Liver Cancer (clinicaltrials.gov)
P2, N=88, Active, not recruiting, National Cancer Institute (NCI) | Trial completion date: Jan 2025 --> May 2025 | Trial primary completion date: Jan 2025 --> May 2025
Trial completion date • Trial primary completion date • Metastases
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IL2 (Interleukin 2)
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Avastin (bevacizumab) • cisplatin • Tecentriq (atezolizumab) • gemcitabine • Aybintio (bevacizumab biosimilar) • Vegzelma (bevacizumab-adcd) • Avzivi (bevacizumab-tnjn)
14d
Testing the Combination of Pevonedistat With Chemotherapy for Bile Duct Cancer of the Liver (clinicaltrials.gov)
P2, N=36, Active, not recruiting, National Cancer Institute (NCI) | N=52 --> 36 | Trial completion date: Dec 2024 --> Oct 2025 | Trial primary completion date: Dec 2024 --> Nov 2023
Enrollment change • Trial completion date • Trial primary completion date • Combination therapy • Metastases
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CD4 (CD4 Molecule) • UBE2M (Ubiquitin Conjugating Enzyme E2 M) • NEDD8 (NEDD8 Ubiquitin Like Modifier)
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carboplatin • paclitaxel • pevonedistat (MLN4924)
14d
Role of Adjuvant Chemotherapy in Distal Cholangiocarcinoma (clinicaltrials.gov)
P=N/A, N=578, Completed, Seoul National University Hospital
New trial
17d
NOTCH1 drives tumor plasticity and metastasis in hepatocellular carcinoma. (PubMed, bioRxiv)
Metastatic cells were enriched in the TGFB and VEGF pathways and their inhibition significantly reduced the metastatic burden. Our novel mouse model uncovered NOTCH1 as a driver of temporal plasticity and metastasis in HCC, the latter of which is, in part, mediated by angiogenesis and TGFß pathways.
Journal
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MYC (V-myc avian myelocytomatosis viral oncogene homolog) • NOTCH1 (Notch 1) • NICD (NOTCH1 intracellular domain)
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MYC overexpression • MYC expression • NOTCH1 overexpression
17d
Emerging insights into ferroptosis in cholangiocarcinoma (Review). (PubMed, Oncol Lett)
Inhibitors of ferroptosis include ferrostatin-1, liproxstatin-1, vitamin E and coenzyme Q10. By contrast, compounds such as erastin, RSL3 and FIN56 have been identified as inducers of ferroptosis...The present review focused on molecular targets such as p53 and ACSL4, the process of targeted medications in combination with PDT in CCA and the pathways of lipid peroxidation, the Xc-system and GSH-GPX4 in ferroptosis. The present review thus offered novel perspectives to improve the current understanding of CCA.
Review • Journal
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GPX4 (Glutathione Peroxidase 4) • ACSL4 (Acyl-CoA Synthetase Long Chain Family Member 4)
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erastin • RSL3 • liproxstatin-1
17d
METTL3-mediated m6A modification promotes chemoresistance of intrahepatic cholangiocarcinoma by up-regulating NRF2 to inhibit ferroptosis in cisplatin-resistant cells. (PubMed, J Chemother)
These findings indicate that the METTL3/NRF2 axis inhibits ferroptosis in cisplatin-resistant cells, thereby promoting chemotherapy resistance in ICC. This provides a potential direction for future research and treatment of ICC.
Journal
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METTL3 (Methyltransferase Like 3)
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cisplatin
17d
New trial • Adverse events
17d
Enrollment change
17d
Study of PF-06940434 in Patients With Advanced or Metastatic Solid Tumors. (clinicaltrials.gov)
P1, N=85, Active, not recruiting, Pfizer | Trial completion date: Aug 2024 --> Dec 2024 | Trial primary completion date: Aug 2024 --> Dec 2024
Trial completion date • Trial primary completion date
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PD-L1 (Programmed death ligand 1)
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PD-L1 expression
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sasanlimab (PF-06801591) • PF-06940434
18d
Virtual Reality for GI Cancer Pain to Improve Patient Reported Outcomes (clinicaltrials.gov)
P=N/A, N=360, Recruiting, Cedars-Sinai Medical Center | Trial primary completion date: Jun 2025 --> Jan 2026
Trial primary completion date • Patient reported outcomes