Bile duct cancer, cancer that occurs in the bile duct, the duct that carries bile made in the liver. Although rare worldwide, it is known to have a relatively high frequency in Korea. Another characteristic of cholangiocarcinoma is its poor prognosis. Bile duct cancer often does not cause any symptoms unless the common bile duct is blocked. In addition, as biliary obstruction develops slowly, it is often only diagnosed after the disease has progressed significantly.
Liver and bile duct｜Source: Getty Image Bank
Poor prognosis…Early detection and surgery are important
According to the Korean Society of Oncology, the average survival time for resectable intrahepatic cholangiocarcinoma is 18 to 30 months, and the average survival time for resectable hilar cholangiocarcinoma is 24 months. If surgical resection is not possible, the survival time is significantly reduced. Intrahepatic bile duct cancer takes about 7 months, and humoral cholangiocarcinoma takes about 8 months.
The best way to increase the survival rate of bile duct cancer is to find it early and treat it with surgery. If surgery is not possible, chemotherapy, radiation therapy, and photodynamic therapy are performed. Chemotherapy is used to treat cancer cells that remain after surgery, and sometimes radiation therapy is used to prevent cancers that have not metastasized from coming back.
What is the latest research related to the treatment of bile duct cancer?
Recently, domestic studies on treatment methods for bile duct cancer, which is an incurable cancer, have come out one after another. According to the research results of Professor Jin Lee’s team at the Department of Gastroenterology at the Dongtan Sacred Heart Hospital of the University of Hallym, published in ‘Oncology Letters’ in December 2022, a component of ursodeoxycholic acid inhibits the epidermal growth factor receptor (EGFR) of cholangiocarcinoma cells which has a preventive action. The research team revealed that ursodeoxycholic acid strongly inhibits the ‘epithelial-mesenchymal conversion’ process of cancer cells, which has a decisive effect on cancer progression and metastasis, and has the effect of preventing the spread of cholangiocarcinoma cells.
Researchers at the National Cancer Center applied protein genome research to bile duct cancer in the liver, an incurable cancer, to identify cancer characteristics and suggest a new treatment strategy that was subdivided. Protein genomic testing is a research approach that takes a step forward from existing genome research and transcriptome research and integrates and analyzes data such as genome, transcriptome, proteome, and phosphoproteinome.
The research team carried out a protein genome study on 102 intrahepatic bile duct cancer tumor tissues and verified the treatment method through a tumor organoid model. Specifically, the research team identified three subtypes: ▲Stem-like ▲Poor immunogenic ▲Metabolism. As a result, it was confirmed that the aldehyde dehydrogenase 1A1 (ALDH1A1) inhibitor reacts with Nab-paclitaxel in the stem cell-like subtype, leading to a greater inhibitory effect.
In addition, abnormal expression of tumor metabolite (Oncomometabolite) in stem cell-like subtype and metabolite subtype was verified to be associated with survival period. The research team succeeded in reproducing these three types of intrahepatic cholangiocarcinoma, and at the same time showed that the characteristics of the tumors were different.
Professor Woo Sang-myung from the National Cancer Center said, “Through this study, we will be able to classify patients with bile duct cancer in the liver according to subtypes and develop a reasonable treatment strategy accordingly to provide treatments after tailor them.”
The results of the study were published online in the latest issue of Gastroenterology, the official journal of the American Gastroenterological Association.