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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The oncology community has stepped up to meet the challenges of the ongoing COVID-19 pandemic but must redouble their efforts in order to stem the potential long-term consequences of this public health crisis on the field. That’s the takeaway from a new letter appearing today in Science Advances, authored by MSK physician-scientist Ross Levine.

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