ASCO updates living guideline on advanced biliary tract cancer care

ASCO's updated living guideline addresses liquid biopsy use and systemic therapy sequencing for advanced biliary tract cancer, based on a systematic review including nine RCTs for first-line therapy and additional studies for second-line options. The guideline recommends broad tissue DNA/RNA NGS testing at diagnosis, reserves plasma liquid biopsy for when tissue is unavailable, recommends immune checkpoint inhibitors plus chemotherapy as first-line therapy for pMMR/MSS disease, and outlines biomarker-specific second-line options including for dMMR/MSI-H, certain mutations, fusions, rearrangements, V600E mutations, and HER2 overexpression.

Most relevant for: Clinicians managing patients with advanced biliary tract cancer, including decisions on first- and second-line systemic therapy and biomarker testing strategy.

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