Precision medicine: A new way to treat biliary cancers
Biomarkers help determine most effective treatments that target your cancer cells.
Advances in biliary tract cancer treatment have made it possible for doctors to select medicines that are targeted to your cancer cells.
Selecting a treatment based on your cancer cells is sometimes called precision medicine. It starts with finding out what makes your cancer cells unique. This is done with testing in a lab. Experts in the lab perform complex analyses on the inner workings of your cancer cells. Then based on the results, your health care team chooses the best treatment.
New discoveries in the area of precision medicine are bringing hope to people with advanced biliary tract cancer.
Testing the cancer cells to find a target
To find out what makes your cancer cells unique, the cells are tested to find biomarkers. Biomarkers are chemicals that can be detected or measured that tell your health care team about what's going on inside your body. In cancer, the biomarkers give information about what's going on inside the cancer cells.
Biomarker testing happens in the lab. A doctor who analyzes blood and body tissue, called a pathologist, directs the testing on a sample of your cancer cells. The sample, called a biopsy, might be taken with a needle or it might be collected during surgery.
In the lab, tests can find out which biomarkers are present. Some tests look for changes in the cancer cells' genetic material, called DNA. Other tests might look for extra chemicals the cancer cells make as a result of those changes. Tests to find substances on the surface of the cancer cells might reveal other biomarkers.
Using the results to choose a treatment
The results of biomarker testing are used to select the right medicine to treat the cancer. This approach might be an option if you can't have surgery for your biliary tract cancer. Surgery might not be possible if the cancer has grown too large to be removed safely or if the cancer has spread. Treatment might begin with medicine instead.
If you have a biomarker that has a matching medicine, then you and your health care team might consider that medicine. Medicines that can be matched to biomarkers include some targeted therapy and immunotherapy medicines.
Many people with biliary tract cancer don't have a biomarker that has a matching medicine. When this happens, medicines that target certain biomarkers aren't likely to be helpful. Other medicines are available, though. Talk to your health care team about chemotherapy and other options.
It's helpful to know what biomarkers are present, even if a matching treatment isn't available. For instance, you may be able to participate in a clinical trial testing new medicines for your biomarkers. As more and more medicines are discovered, one that targets your biomarkers may one day be available.
Looking to the future of precision medicine
Precision medicine is an active area of cancer research. Innovations in lab tests are helping researchers find new biomarkers that could inform treatment in the future. The discoveries are leading to new medicines.
March 24, 2023
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- Biomarker testing for cancer treatment. National Cancer Institute. https://www.cancer.gov/about-cancer/treatment/types/biomarker-testing-cancer-treatment. Accessed Feb. 17, 2023.
- Scott AJ, et al. Precision medicine in biliary tract cancer. Journal of Clinical Oncology. 2022; doi:10.1200/JCO.21.02576.
- Hepatobiliary cancers. National Comprehensive Cancer Network. https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1438. Accessed Feb. 14, 2023.