Biliary Tract Cancer
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Oct 12 – Oct 19, 2026
Treatment of Advanced Biliary Tract Cancer: ASCO Living Guideline, Version 2026.1.0.
J CLIN ONCOL · Q1 JOURNAL - RANK #6/326TOP-TIER
This ASCO living guideline provides evidence-based recommendations for liquid biopsy and systemic treatment of advanced biliary tract cancer (BTC), developed by an Expert Panel conducting a systematic review of relevant studies including RCTs. It recommends broad-based tissue NGS testing at diagnosis, with liquid biopsy for unavailable tissue. First-line therapy for pMMR/MSS advanced BTC is ICIs plus chemotherapy, while pembrolizumab monotherapy is an option for dMMR/MSI-H BTC. The guideline offers specific, actionable treatment options for various BTC patient subgroups, including those with disease progression or specific biomarkers (e.g., FGFR2, IDH1, BRAF V600E, HER2, NTRK fusions), directly impacting clinical decision-making in oncology.
10.1200/JCO-26-02462
Sep 21 – Sep 28, 2026
Five-Year Follow-Up of the Phase III ASCOT Trial of Adjuvant S-1 After Resection for Biliary Tract Cancer.
J CLIN ONCOL · Q1 JOURNAL - RANK #6/326TOP-TIER
This phase III multicenter trial evaluated the long-term efficacy of adjuvant S-1 versus observation in 440 Japanese patients with resected biliary tract cancer. At a median follow-up of 61.5 months, the S-1 group demonstrated a significantly higher 5-year overall survival rate of 64% compared to 52% in the observation group (HR 0.72). Median overall survival was extended to 8.2 years with S-1 treatment, while stratified relapse-free survival also showed improvement (HR 0.76). These findings confirm that adjuvant S-1 provides a sustained survival benefit, establishing it as a standard treatment option for patients following biliary tract cancer resection.
10.1200/JCO-26-00017
Trastuzumab plus nivolumab with gemcitabine and cisplatin as first-line therapy for HER2-positive unresectable biliary tract cancer: a phase 1b/2 trial.
NAT MED · Q1 JOURNAL - RANK #1/195TOP-TIER
This phase 1b/2 HERBOT study evaluated a first-line HER2-targeted quadruplet regimen (trastuzumab, nivolumab, gemcitabine, cisplatin) for HER2-positive advanced unresectable biliary tract cancer (BTC). The primary endpoint was met with an objective response rate of 55% (95% CI 38.5-70.7) and a disease control rate of 95% among 40 participants. Median progression-free survival was 10.6 months (95% CI 7.8-17.4), and median overall survival was not reached, with 5% undergoing conversion surgery. These findings suggest upfront HER2-targeted therapeutic intensification is a promising first-line strategy for HER2-positive BTC, relevant to ongoing phase 3 studies.
10.1038/s41591-026-04679-x