Prognostic biomarkers for cholangiocarcinoma and their clinical implications

ABSTRACT

Introduction: Cholangiocarcinoma (CCA) is a poorly prognostic cancer with limited treatment options. Most patients have unresectable tumors when they are diagnosed and the chemotherapies provided are of limited benefit. Prognostic markers are therefore necessary to predict the disease outcome, risk of relapse, or to suggest the best treatment option.

Areas covered: This article provides an up-to-date review of biomarkers with promising characteristics to be prognostic markers for CCA reported in the past 5 years. The biomarkers are sub-classified into tissue and serum markers. Proteins, RNAs, peripheral blood cells etc., that are associated with aggressive phenotypes, signal pathways, chemo-drug resistance, and those that reflect the survival time of CCA patients are evaluated for their prognostic prediction values.

Expert commentary: CCAs are heterogeneous tumors of different histo-pathological subtypes and genetic influences and, therefore, potential markers should be validated in larger collectives with varied epidemiological backgrounds. A systematic review and meta-analysis should be done to clarify the impact of the reported biomolecules for their potential prognostic values. Non- or low-invasive sample collections, as well as the simple and affordable determination methods, should be constructed to make the prognostic biomarkers available in clinical practice.

KEYWORDS:

• CA19-9
• diagnosis
• drug resistance
• miRNAs
• neutrophil-to-lymphocyte ratio
• non-coding RNA
• overall survival
• signaling pathways
• tumor microenvironment
• tumor stromal

Acknowledgments

We would like to acknowledge Prof. James A. Will of the University of Wisconsin for editing of the manuscript via the Faculty of Medicine Publication Clinic, Khon Kaen University, Thailand; and Dr. C. Phoomak, Department of Biochemistry, Faculty of Medicine, Khon Kaen University, for creating the figure of this presentation.

Declaration of interest

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This work is supported by The Thailand Research Fund [DBG5980004].