Biliary tract cancer (all types)
Prepared with OnCo (onco.cc/prep/biliary-tract-cancer/). Orientation, not medical advice; your team knows your case.
My details
What I know, what is unclear, changes to discuss
Saved in this browserMy questions
16 on the sheet- 1.What is my exact diagnosis, stage, and grade, and which tests established them?
- 2.Which biomarkers have been tested on my tumour (for example FGFR2 fusions and IDH1 mutations, HER2 amplification, Microsatellite instability, CA 19-9), and what were the results?
- 3.Which subtype is my cancer, and does that change the recommended treatment?
- 4.Is germline (inherited) genetic testing recommended for me or my family?
- 5.For my situation (resectable disease), which of the standard options do you recommend and why?
- 6.Am I a candidate for Capecitabine, and what side effects should I expect?
- 7.How do the results of BILCAP apply to someone like me?
- 8.For my situation (advanced disease), which of the standard options do you recommend and why?
- 9.Am I a candidate for Gemcitabine, Cisplatin, Durvalumab, and what side effects should I expect?
- 10.For my situation (second line by biology), which of the standard options do you recommend and why?
- 11.Am I a candidate for Pemigatinib, Futibatinib, Ivosidenib or related drugs, and what side effects should I expect?
- 12.Are there clinical trials I could join, for example of Pemigatinib, Futibatinib, Ivosidenib?
- 13.Would a second opinion at a high-volume centre change anything, and can you help arrange it?
- 14.What supportive care (symptom control, nutrition, exercise, mental health, financial help) is available from the start?
- 15.I read that “Most patients are diagnosed too late for surgery”. How does that affect my plan?
- 16.I read that “No screening even in high-incidence regions”. How does that affect my plan?
Tests and results to bring
Biomarker results to ask for: FGFR2 fusions and IDH1 mutations (intrahepatic), HER2 amplification (gallbladder, extrahepatic), Microsatellite instability, CA 19-9.
Bring copies of scan reports, pathology and blood results, and a list of every medicine and supplement.
The treatments I may be offered
- Resectable disease: Surgery followed by six months of capecitabine (BILCAP). (BILCAP, Capecitabine)
- Advanced disease: Gemcitabine-cisplatin with durvalumab (TOPAZ-1) or pembrolizumab; targeted therapy for FGFR2 and IDH1 alterations on progression. (Biliary tract cancer (cholangiocarcinoma), Gemcitabine, Cisplatin, Durvalumab)
- Second line by biology: Pemigatinib or futibatinib for FGFR2 fusions, ivosidenib for IDH1 mutations, FOLFOX otherwise. (Pemigatinib, Futibatinib, Ivosidenib, Oxaliplatin)
From the standard of care recorded for this cancer; which apply depends on your stage and biomarkers. Ask which the team recommends and why.