Targeted immunotherapy approaches for intraductal papillary neoplasm of the bile duct

Document Type : Editorial

Authors

1 Department of Regenerative Medicine, Cell Science Research Center, Royan institute for stem cell biology and technology, ACECR, Tehran, Iran.

2 Department of Regenerative Medicine, Cell Science Research Center, Royan institute for stem cell biology and technology, Tehran, Iran

Abstract

Abstract: Intraductal papillary neoplasm of the bile duct (IPNB) is a complex biliary tract
neoplasm. Its classifications based on distinct clinical, pathological, and
radiological features and gene mutations, are of paramount importance. The
classification of IPNB into Type 1 and Type 2 has proven essential, as these
subtypes present notably different molecular alterations and clinical behaviors.
Type 1 IPNBs are characterized by KRAS, GNAS and RNF43 mutations. While,
Type 2 IPNBs demonstrate TP53, SMAD4, and KMT2C mutations. Recognition of
the subclasses along with the genetic alterations enables early detection and
advancement of personalized therapeutic methods. In addition, the identification of
more involved signaling pathways and their crosstalk are indispensable for the
advancement of novel therapeutic approaches including targeted immunotherapy
and gene therapy. These tailored approaches hold the promise of improving patient
outcomes, minimizing side effects, and offering a brighter future for those afflicted
by this intricate biliary neoplasm.The precise classification of IPNB besides the accurate identification of mutations and molecular alteration in each subclassification lead to the development of more accurate and efficient diagnostic and therapeutic methods.

Keywords


1. Mocchegiani F, Vincenzi P, Conte G,
Nicolini D, Rossi R, Cacciaguerra
AB, et al. Intraductal papillary
neoplasm of the bile duct: The
new frontier of biliary pathology.
2023;29(38):5361-73.
2. Wu X, Li B, Zheng C, Chang X,
Zhang T, He X, et al. Intraductal
papillary neoplasm of the bile duct:
a single-center retrospective study.
2018;46(10):4258-68.
3. Li B, Liu Z, Meng Z, Li M, Tian
W, Liu QJFiO. Surgical Treatment
of Intraductal Papillary Neoplasm
of the Bile Duct: A Report of Two
Cases and Review of the Literature.
2022;12:916457.
4. Luvira VJAoH. Progression of
intraductal papillary neoplasm of
the bile duct (IPNB): A proposed
model through the observation of
patients with non-resected tumors.
2020;23:100299-.
5. Rossi RE, Massironi SJErog,
hepatology. Intraductal papillary
mucinous neoplasms of the
pancreas: a clinical challenge.
2018;12(11):1123-33.
6. Kubota K, Jang JY, Nakanuma Y, Jang
KT, Haruyama Y, Fukushima N, et al.
Clinicopathological characteristics of
intraductal papillary neoplasm of the
bile duct: a Japanā€Korea collaborative
study. 2020;27(9):581-97.
7. Normanno N, Martinelli E, Melisi D,
Pinto C, Rimassa L, Santini D, et al.
Role of molecular genetics in the clinical
management of cholangiocarcinoma.
2022;7(3):100505 8. Manne A, Woods E, Tsung A, Mittra
AJFiO. Biliary tract cancers: treatment
updates and future directions in
the era of precision medicine and
immuno-oncology. 2021;11:768009.
9. Lluís N, Onoe S, Serradilla-Martín
M, Achalandabaso M, Mizuno T,
Jehaes F, et al. Intraductal papillary
neoplasms of the bile ducts: a
comparative study of a rare disease
in Europe and Nagoya, Japan. 2024.
10. Yang C-Y, Huang W-J, Tsai J-H,
Cheng A, Chen C-C, Hsu H-P, et al.
Targeted next-generation sequencing
identifies distinct clinicopathologic
and molecular entities of intraductal
papillary neoplasms of the bile duct.
2019;32(11):1637-45.
11. Aoki Y, Mizuma M, Hata T, Aoki T,
Omori Y, Ono Y, et al. Intraductal
papillary neoplasms of the bile duct
consist of two distinct types specifically
associated with clinicopathological
features and molecular phenotypes.
2020;251(1):38-48.
12. Xian Z-H, Qin C, Cong W-MJP-
R, Practice. KRAS mutation and
immunohistochemical profile in
intraductal papillary neoplasm
of the intrahepatic bile ducts.
2018;214(1):105-11.
13. Fujikura K, Akita M, Ajiki T,
Fukumoto T, Itoh T, Zen YJTAJoSP.
Recurrent mutations in APC and
CTNNB1 and activated Wnt/β-
catenin signaling in intraductal
papillary neoplasms of the bile duct.
2018;42(12):1674-85.
14. Tsai JH, Liau JY, Yuan CT, Cheng
ML, Yuan RH, Jeng YMJH. RNF
43 mutation frequently occurs
with GNAS mutation and mucin
hypersecretion in intraductal
papillary neoplasms of the bile duct.
2017;70(5):756-65.
15. Nakanuma Y, Uesaka K, Kakuda Y,
Sugino T, Kubota K, Furukawa T, et
al. Intraductal papillary neoplasm of
bile duct: updated clinicopathological
characteristics and molecular and
genetic alterations. 2020;9(12):3991.
16. Pavlidis ET, Galanis IN, Pavlidis
TEJWJoG. Current considerations
on intraductal papillary neoplasms
of the bile duct and pancreatic duct.
2024;30(10):1461.
17. Rezatabar S, Karimian A, Rameshknia
V, Parsian H, Majidinia M, Kopi TA,
et al. RAS/MAPK signaling functions
in oxidative stress, DNA damage
response and cancer progression.
2019;234(9):14951-65.
18. Heppner DE, Eck MJJPS. A structural
perspective on targeting the RTK/
Ras/MAP kinase pathway in cancer.
2021;30(8):1535-53.