Objective To summarize the research status and prospect of immunotherapy for biliary tract cancer (BTC). Method The literatures about immunotherapy of BTC at home and abroad in recent years were reviewed. Results Surgical resection was still the first choice and only radical treatment for BTC. However, the recurrence rate of BTC was high, and most of the patients were in the middle and late stage with metastasis and lose the opportunity of operation. Patients with local progression, metastasis or recurrence could only receive chemotherapy and other comprehensive treatment, but they could not get satisfactory results. The continuous update of targeted drugs brings new hope for drug therapy of BTC, and immunotherapy had become a new treatment of tumor targeted therapy following radiotherapy and chemotherapy. ConclusionImmunotherapy can be used as an option for the treatment of advanced BTC and its postoperative recurrence and metastasis, and has attracted more and more attention.
ObjectiveTo analyze the trends in the disease burden of gallbladder and biliary tract cancer (GBTC) and the quality of care index (QCI) in China from 1990 to 2023, so as to provide references for targeted prevention and control. MethodsData from the Global Burden of Disease 2023 (GBD 2023) were used to extract indicators including incidence, prevalence, mortality, and disability-adjusted life years (DALYs) of GBTC, and the QCI was established. Joinpoint regression and age-period-cohort models with Wald test were adopted for trend analysis. The autoregressive integrated moving average model was applied to predict the changing trends from 2024 to 2035. ResultsCompared with the levels in 1990, the numbers of incident cases, prevalent cases, and deaths of GBTC in China in 2023 increased by 136.6%, 213.7%, and 82.8%, respectively; while DALYs, years lived with disability, and years of life lost increased by 52.8%, 151.8%, and 51.9%, respectively. The QCI for GBTC in China increased in the overall population and by gender (female and male), with increments of 59.90, 54.82, and 63.79, respectively. The age-standardized incidence rate, age-standardized mortality rate, and age-standardized DALYs rate of GBTC in China all decreased from 1990 to 2023, with cumulative declines of 14.1%, 36.2%, and 40.8%, respectively; however, the age-standardized prevalence rate increased, with a cumulative increase of 19.8%. The age-period-cohort model analysis showed that age effects were statistically significant for crude incidence, crude prevalence, crude mortality, and crude DALYs rates (all P<0.01), while period and cohort effects were statistically significant only for crude DALYs rate (P<0.01). From 1990 to 2023, the crude incidence, prevalence, and mortality rates of GBTC in China fluctuated upward. These metrics are projected to continue rising, reaching 3.91, 6.15, and 2.66 per 100 000, respectively, by 2035. In contrast, the crude DALYs rate trended downward and is expected to decline slightly, stabilizing at approximately 51.74 per 100 000 during 2024–2035. The QCI also followed a fluctuating upward trajectory, with a projected further increase to 88.67 by 2035, with gender differences between males and females. ConclusionsThe absolute disease burden of GBTC in China increased continuously from 1990 to 2023. All age-standardized rates declined except the age-standardized prevalence rate, while care quality improved substantially. These trends suggest that, against the backdrop of population aging, sustained efforts are needed to strengthen prevention, control and standardize diagnosis and treatment in the future.
ObjectiveTo systematically analyze the temporal trends in the burden of gallbladder and biliary tract cancer (GBTC) in Yunnan Province, China, from 1990 to 2021 using the Global Burden of Disease Study 2021 (GBD 2021), and to project the disease burden through 2030 to inform regional prevention and control strategies. MethodsData on crude prevalence, mortality, and disability-adjusted life year (DALY) rates for GBTC in Yunnan Province, China, from 1990 to 2021 were extracted from GBD 2021. Temporal trends in the age-standardized prevalence, mortality, and DALY rates (ASPR, ASMR, and ASDR) were analyzed using Joinpoint regression models, and the average annual percent change (AAPC) was calculated. Furthermore, the Bayesian age-period-cohort (BAPC) model was employed to project the disease burden from 2022 to 2030. ResultsFrom 1990 to 2021, the crude prevalence, mortality, and DALY rates of GBTC in Yunnan Province increased from 1.01/100 000, 1.00/100 000, and 27.50/100 000 in 1990 to 3.00/100 000, 1.78/100 000, and 43.29/100 000 in 2021, respectively. After age standardization, the ASPR showed an upward trend (AAPC=1.29%), whereas the ASMR (AAPC=–0.58%) and ASDR (AAPC=–0.70%) exhibited downward trends. Regarding sex disparities, the increase in ASPR was more pronounced in males than in females (AAPC: 1.88% vs. 0.67%), while the declines in ASMR and ASDR were less steep in males than in females (ASMR AAPC: –0.20% vs. –0.92%; ASDR AAPC: –0.29% vs. –1.06%). Age-stratified analysis revealed that the ASPR increase was most prominent in the 30–34-year age group (AAPC=2.63%), and the reductions in ASMR and ASDR were most substantial in the 50–59-year age group (AAPC: –1.20% and –1.18%, respectively). Projections based on the BAPC model indicate that by 2030, the ASPR will continue to rise to 3.17/100 000, whereas the ASMR and ASDR are projected to decline gradually to 1.44/100 000 and 34.86/100 000, respectively. ConclusionsThe absolute disease burden of GBTC in Yunnan Province keeps rising. While the ASMR and ASDR have shown a declining trend, the steady growth in the ASPR points to a substantial accumulation of prevalent cases. Future public-health programmes should prioritise targeted early-detection and treatment strategies for the young- and middle-aged population.