Second-line systemic treatment for advanced cholangiocarcinoma

Biliary tract cancers (BTC) are a heterogeneous group of rare malignancies that include gallbladder cancer, ampullary cancer, and intrahepatic, hilar, and extrahepatic cholangiocarcinoma. In the United States, there are estimated to be 10,310 new cases in 2013 with 3,230 estimated deaths (1). Cholangiocarcinomas, tumors that originate in the bile duct epithelium, are further sub-classified into intrahepatic, extrahepatic, and hilar depending on the location of the primary tumor in the biliary tree. Due to the rarity of these malignancies, trials often combine these heterogeneous BTC, making it difficult to determine patient outcomes and therapeutic decisions specifically for cholangiocarcinoma