Nab-paclitaxel plus capecitabine as a first-line regimen for advanced biliary tract cancers: Feasible or not feasible?

Sep 23, 2026

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A clinical trial evaluating nab-paclitaxel plus capecitabine as first-line treatment for advanced biliary tract cancers (BTCs) was presented in a Letter to the Editor context. The analysis reviews the evolution of systemic therapy recommended by National Comprehensive Cancer Network guidelines and summarizes prior development of nab-paclitaxel-based combination chemotherapy for advanced BTCs. The conclusion states that nab-paclitaxel plus capecitabine represents a promising first-line regimen for advanced BTC patients.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages6

Reading Time15 min

AccessFree to download

Letter to the editor

Abstract and key conclusion

Development of systemic therapy for advanced BTCs

| W | J | G | World Journal of
Gastroenterology | | --- | --- | --- | --- | Submit a Manuscript: [https://www.f6publishing.com](https://www.f6publishing.com) World J Gastroenterol 2025 March 14; 31(10): 100771 DOI: 10.3748/wjg.v31.i10.100771 ISSN 1007-9327 (print) ISSN 2219-2840 (online) LETTER TO THE EDITOR Nab-paclitaxel plus capecitabine as a first-line regimen for advanced biliary tract cancers: Feasible or not feasible? Jian-Qiang Chen, Xiang Lan Specialty type: Gastroenterology and hepatology Provenance and peer review: Invited article; Externally peer reviewed. Peer-review model: Single blind Peer-review report’s classification Scientific Quality: Grade C, Grade C, Grade C, Grade C, Grade D Novelty: Grade B, Grade B, Grade B, Grade C, Grade C Creativity or Innovation: Grade B, Grade B, Grade C, Grade C, Grade D Scientific Significance: Grade B, Grade B, Grade C, Grade C, Grade C P-Reviewer: Habib S; Kobayashi S; Xu M Received: August 26, 2024 Revised: January 10, 2025 Accepted: February 10, 2025 Published online: March 14, 2025 Processing time: 184 Days and 7.2 Hours Jian-Qiang Chen, Xiang Lan, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China Corresponding author: Xiang Lan, MD, Doctor, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuanjiagang, Yuzhong District, Chongqing 400016, [China.](China. lanxiangkeyan@163.com)[ lanxiangkeyan@163.com](China. lanxiangkeyan@163.com) Abstract A clinical trial of nab-paclitaxel plus capecitabine as a first-line treatment for advanced biliary tract cancers was conducted. We analyzed the development of systemic therapy recommended by the National Comprehensive Cancer Network guidelines and the development of nab-paclitaxel combination chemotherapy for advanced biliary tract cancers (BTCs) and concluded that nab-paclitaxel plus capecitabine is a promising first-line regimen for advanced BTCs. Key Words: Nab-paclitaxel; Capecitabine; Biliary tract cancers; Systemic therapy; Firstline regimen ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved. Core Tip: We investigated the development and efficacy of systemic therapy for advanced biliary tract cancers (BTCs) and concluded that paclitaxel plus capecitabine is a promising first-line regimen for advanced BTCs. Citation: Chen JQ, Lan X. Nab-paclitaxel plus capecitabine as a first-line regimen for advanced biliary tract cancers: Feasible or not feasible? World J Gastroenterol 2025; 31(10): 100771 URL: [https://www.wjgnet.com/1007-9327/full/v31/i10/100771.htm](https://www.wjgnet.com/1007-9327/full/v31/i10/100771.htm) DOI: [https://dx.doi.org/10.3748/wjg.v31.i10.100771](https://dx.doi.org/10.3748/wjg.v31.i10.100771) TO THE EDITOR Biliary tract cancers (BTCs), which include intrahepatic cholangiocarcinoma, extrahepatic cholangiocarcinoma and gallbladder cancer, constitute approximately 4% of all malignant gastrointestinal tract neoplasms and are considered rare forms of tumors WJG [https://www.wjgnet.com](https://www.wjgnet.com) 1 March 14, 2025 Volume 31 Issue 10 Chen JQ et al. Nab-paclitaxel plus capecitabine for advanced BTCs [1] . However, the prognosis of BTC is poor, with a 5-year overall survival (OS) of less than 20%[2] . Patients are usually diagnosed with advanced-stage BTCs when they have tumors, and systemic therapy has become the only choice for these patients. More than 10 years ago, the combination of chemotherapy with gemcitabine and cisplatin became the standard-of-care first-line therapy for advanced biliary tract cancer. Nevertheless, the median OS of patients receiving this doublet chemotherapy is still less than 1 year [3,4] . In recent years, immune checkpoint inhibitors, including durvalumab and pembrolizumab, have been proven effective in advanced BTCs. Chemotherapy inv

FAQs

What treatment combination is evaluated for advanced biliary tract cancers?

Nab-paclitaxel plus capecitabine is evaluated as a first-line regimen for advanced biliary tract cancers.

How does the letter position its main conclusion?

It concludes that nab-paclitaxel plus capecitabine is a promising first-line regimen for advanced BTCs based on analysis of systemic therapy development.

Which prior systemic therapies are discussed in the development overview?

The letter discusses chemotherapy standards such as gemcitabine plus cisplatin, immune checkpoint inhibitor–based first-line approaches, and earlier clinical trial evidence including phase II results using nab-paclitaxel plus capecitabine.

Sep 23, 2026

Uploaded by Ezra