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Molecular profiling
No two tumours are exactly the same. The genetic characteristics of a cancer will vary from one patient to the next, which means that even patients with the same type of cancer may respond differently to the same treatment. We are now learning that molecular profiling may allow patients to benefit from more ‘personalised’ treatments.
Molecular profiling is the classification of samples (e.g. tumour tissue) based on gene expression. Biopsy samples are sent to a laboratory where they undergo tests to analyse tumour DNA and proteins – the results of these tests provide information about the molecular profile of the tumour and can be used to help decide which treatments the cancer is likely to respond to.
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In recent research, molecular profiling has identified differences between types of biliary tract cancer, and it is hoped that a better understanding of the molecular pathology of biliary tract cancer might one day help with the development of new therapies (Valle et al., 2016).
For example, mutations in certain genes, including genes called IDH1 and FGFR2, are each found in 10–15% of intrahepatic CCAs, and drugs that target these alterations are currently in clinical development (Mertens et al., 2018) . An inhibitor of IDH1 called ivosidenib has recently been shown to improve outcomes when compared with placebo in patients with previously-treated CCA (Abou-Alfa et al., 2019). It is likely that, in the future, molecular profiling of biliary tract cancer will be essential to ensure that treatment is tailored for each patient.
