Abstract
Cancer of the biliary tract (CBT) are relatively uncommon types of tumors. They are frequently diagnosed at a late stage with weak response to conventional therapies such as chemotherapy and radiotherapy. Thus a totally new and different treatment approach is needed. There is growing evidence about its genomic pathophysiolgy which may alter our notions regarding this disease. Numerous molecular pathways have been implicated and many may be targeted by new agents with high hopes for our patients. We review here the molecular background and the genetic / epigenetic abnormalities of the two main types of cancer of the biliary tract, gall bladder cancer (GBC) and cholagiocarcinoma (CC). Immunotherapy has become the promising new approach for many neoplasm, including CBT. We will go over the available evidence behind the current and emerging immunotherapeutics in CBT. They are categorized as Food Drug Association (FDA) or not approved, as there is an abundant number of new agents under examination, as monotherapies or in combinations with conventional chemotherapy, in clinical trials. More research is required at the molecular basis of CBT tumorigenesis in order to reach an individualized targeted therapy.