Immunotherapy for Biliary Tract Cancer

CE / CME

Integrating New Developments in Initial Systemic Treatment in Biliary Tract Cancer Into Clinical Practice: A Spotlight on Immunotherapy

Physician Assistants/Physician Associates: 1.00 AAPA Category 1 CME credit

Nurses: 1.00 Nursing contact hour

Pharmacists: 1.00 contact hour (0.1 CEUs)

Physicians: maximum of 1.00 AMA PRA Category 1 Credit

Released: October 29, 2024

Expiration: April 28, 2025

Lipika Goyal
Lipika Goyal, MD, MPhil

Pretest

Progress
1 2 3
Course Completed
Please answer the questions below.
1.

Which of the following currently has a disease agnostic FDA approval for MSI-high/dMMR solid tumors?

2.

Case: A 34-Yr-Old Man With Metastatic ICC



  • 34-yr-old man originally from Thailand presenting with abdominal pain

  • Exam: mild RUQ tenderness to palpation

  • Labs: Na 134 mmol/L, Cr 1.0 mg/dL, AST 44 U/L, ALT 164 U/L, Tbili 1.2 mg/dL,  Alb 3.9 g/dL, calcium12.3 mg/dL

  • Radiology: CT chest/abdomen/pelvis: 7-cm mass in the right hepatic lobe with multifocal liver lesions and multiple bilateral 8- to 10-mm lung nodules

  • EGD/colonoscopy and PET scan show no evidence of a primary lesion 

  • Core liver biopsy: CK7+, CK19+, CK20-, CDX2- adenocarcinoma

  • Diagnosis: metastatic intrahepatic cholangiocarcinoma

Which of the following treatments would you recommend as first-line systemic therapy for this patient? 

3.

Case: A 67-Yr-Old Man With Metastatic GBC



  • 67-yr-old man with metastatic gallbladder cancer presents on cycle 3, Day 1 of pembrolizumab plus gemcitabine and cisplatin with 1 wk of diarrhea 

  • He is currently experiencing 9 episodes of loose bowel movements per day 

  • He denies fevers, chills, bloody stools, foul-smelling stools, nausea, and vomiting

  • Labs: K 3.1, Cr 1.5, Mg 1.8, ALT 34, AST 24, Tbili 1.1

  • Patient receives IV fluid, electrolyte repletion and loperamide without relief

Which of the following would you recommend as the next step of management for grade 3 diarrhea?