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ACTICCA-1 comparing capecitabine to gemcitabine and cisplatin, the current standard of care in advanced
and metastatic disease. This trial has the added possibility of demonstrating benefit with chemoradiotherapy
in R1 disease. While evidence exists suggesting systemic chemotherapy, either alone or in combination with
radiotherapy, may downstage unresectable biliary tracts cancers resulting in surgery, the benefit of
neoadjuvant therapy in resectable tumors is less clear. What is evident in reviewing the literature is that
significant improvements in the management of potentially curable biliary tract cancers have not been
eventuated and that more work needs to be done. Given the rarity and difficulty in performing large,
statistically powered clinical trials, collaborations between research groups around the world are necessary
to drive an improvement in patient outcomes.
DECLARATIONS
Acknowledgments
The authors would like to acknowledge Kelly D for her review and input regarding the final draft.
Authors’ contributions
Research and manuscript design: Allen MJ
Drafted the manuscript: Allen MJ
Draft edits and final manuscript preparation: Allen MJ, Knox JJ
Availability of data and materials
Not applicable.
Financial support and sponsorship
None.
Conflicts of interest
Both authors declared that there are no conflicts of interest.
Ethical approval and consent to participate
Not applicable.
Consent for publication
Not applicable.
Copyright
© The Author(s) 2021.
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