Cancer’s ability to resist chemotherapy has been a roadblock to achieving lasting remissions or cures. Scientists have believed that unique genetic mutations in tumors may be to blame for drug resistance. However, they are starting to look at nongenetic changes in cancer cells to explain their adaptability. An example of this is cancer’s ability to change its identity. A prostate cancer cell that is sensitive to hormone-blocking therapy might change into a cell type that does not require the hormone for its growth. This heterogeneity creates obstacles for treatment, since a single drug is unlikely to work against so many different cell types.

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A recent FDA action for the FGFR1/2/3 inhibitor pemigatinib (Pemazyre) marked the first approval of a targeted agent for cholangiocarcinoma, and the oncology field is likely to see additional systemic therapy approvals for bile duct cancers. The incidence of biliary tract cancers, which are typically broken down into subgroups of intrahepatic cholangiocarcinoma, extrahepatic cholangiocarcinoma, and gallbladder cancer, are rising, which experts associate with obesity and other etiologic risk factors. 

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As part of the EAU 2020 virtual meeting, the prostate cancer session highlighted a series of talks on the primary treatment of pelvic lymph node metastatic prostate cancer. Karim Touijer, MD, MPH, discussed the role of surgery alone for these patients. 

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