Dr. Gordan on Molecular Diagnostics in Biliary Tract Cancers

John Gordan, MD, PhD, assistant professor, Division of Hematology/Oncology, at the University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, discusses how the adoption of molecular diagnostics has helped further treatment efforts in biliary tract cancers.

Researchers are now defining therapeutically targetable subsets for which there are potent and active agents. FGFR2 inhibitors, for example, are active in a subset of patients with oncogenic fusions of the tyrosine kinase receptor.

IDH1 inhibitors are showing potency in 15% to 25% of patients with cholangiocarcinoma who have an IDH1 mutation, Gordan says. These agents have been “dramatic” in their application; it’s hard to express the enthusiasm of this option in the second-line setting to a population that has been an unmet need, states Gordan. The clinical results that are coming out of phase I/II studies are encouraging, but also remain quite preliminary.

Encouraging providers to undertake molecular diagnostics earlier in the evaluation process is critical, so that these mutations are found and patients can enroll in clinical trials, he says.