Chimiothérapie systémique des cancers biliaires avancés

Gemcitabine-cisplatin combination (GEMCIS regimen) is the first standard for first-line palliative chemotherapy in patients with advanced biliary tract cancer and correct performance status. Despite the absence of randomized controlled trials comparing GEMCIS and gemcitabine-oxaliplatin (GEMOX) regimens, the latter represents an interesting option. No data allow currently to define a standard for second-line and further therapies. Future therapeutic advances will likely come from the combination of targeted agents with chemotherapy, with selection of patients on tumor oncogenic alterations of interest.