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Research

Bile duct cancer is rare which makes it a difficult cancer to study. But researchers around the world are continuing to learn more about its development and finding ways to try and diagnose it earlier. They are also looking into different treatments to try to improve people’s outlook and their quality of life.

If you are interested in UK clinical trials for bile duct cancer, go to Cancer Research UK’s clinical trials database.

Causes

Doctors want to learn more about why bile duct cancer starts. Some researchers in Europe are looking into the causes and risk factors for bile duct cancer. As part of their research they are looking at blood and tumour samples from people diagnosed with bile duct cancer, and how they change over time. They also want to see how certain risk factors may affect a person’s outcome.

Tests to diagnose bile duct cancer

Cancer of the bile ducts is often diagnosed at an advanced stage. Researchers want to find better ways of diagnosing this type of cancer, and at an earlier stage.

Researchers are looking for genes and proteins that may act as markers of cancer or pre cancerous changes. Researchers are also looking at using different types of scans to pick up tumours in the liver more clearly.

Chemotherapy

Chemotherapy after surgery

Chemotherapy after surgery can help to stop some types of cancer coming back. So researchers have been looking into this for bile duct cancer.

Following the results of the BILCAP trial, doctors now give a chemotherapy drug called capecitabine after surgery for bile duct cancer.

The ACTICCA-1 trial is looking at giving the chemotherapy drugs gemcitabine and cisplatin after surgery to remove bile duct cancer.

Chemotherapy for advanced bile duct cancer

Doctors usually give a combination of cisplatin and gemcitabine for advanced bile duct cancer. But researchers around the world continue to look for new drugs or different combinations of drugs, including:

  • oxaliplatin and fluorouracil (5FU)
  • cisplatin and a new drug similar to gemcitabine, called Acelarin
  • fluorouracil, irinotecan and oxaliplatin (FOLFIRINOX)

Researchers are looking at giving chemotherapy on its own or with other treatments such as radiotherapy or surgery.

Radiotherapy

Researchers continue to look at new and different ways of giving radiotherapy, and to learn more about the side effects and how to reduce them.

Internal radiotherapy

Doctors continue to look at a new type of internal radiotherapy called selective internal radiation therapy (SIRT) or radioembolisation for bile duct cancers in the liver.

Millions of tiny beads (sometimes called microspheres) are fed into the hepatic artery, the main blood vessel which supplies the liver. These beads block the supply of blood to the cancer. They contain a radioactive substance called yttrrium-90, so they also work by sending out radiation. This helps to kill off the cancer cells.

Trials are looking at giving SIRT before or after chemotherapy that goes around the body (systemic chemotherapy).

External radiotherapy

External radiotherapy means you have radiation from a machine outside your body. Some researchers are looking at giving stereotactic radiotherapy (SBRT) after treatment with the chemotherapy drugs cisplatin and gemcitabine.

SBRT directs radiotherapy beams at the cancer from different positions around the body. It delivers a high dose of treatment to the cancer while the surrounding tissue only receives a low dose.

Targeted cancer drugs

Targeted cancer drugs change the way that cells work. They can boost the body’s immune system to fight off or kill cancer cells. Or they can block signals that tell cells to grow.

Researchers have been looking into different types of targeted drugs for bile duct cancer.  These drugs include:

  • selumetinib
  • cetuximab
  • sorafenib
  • cedirinib

So far the research into these drugs have not shown a significant benefit. But researchers are continuing to study bile duct cancer cells to try to find suitable targets for this type of treatment.

Last reviewed: 
16 Aug 2018
  • Cancer: Principles and Practice of Oncology (10th edition)
    VT De Vita, TS Lawrence and SA Rosenberg
    Lippincott, Williams and Wilkins, 2015

  • Biliary cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow up
    JW Valle and others
    Annals of Oncology, 2016. Volume 27, Supplement 5, Pages 28 - 37

  • Cancer Research UK's clinical trials database
    Accessed 16/08/2018

  • ClinicalTrials.gov
    US National Library of Medicine
    Accessed 16/08/2018

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