Ampulla of Vater Carcinoma

Reduced survival rates were seen in populations with the TP53 or KRAS mutation. This study provides a detailed descriptive genomic landscape of ampullary carcinoma, highlighting frequent mutations between patient groups and the mutational burden of the DNA damage response pathway in ampullary cancer, laying important groundwork for the development of therapeutic targets and more individualized treatment regimens.

The PB subtype showed a higher pathological tumor stage than INT. Among the various schemas evaluated, the Harthimmer Integrated Liu Layered Scoring system performed best with a significant correlation between HE and IHC subtypes. INT subtypes had better prognostic outcomes than PB subtypes. We found an essential prognostic role of CDX2 in the stratification of ACs.

Histopathological examination of the biopsy specimen obtained before treatment initiation revealed intestinal-type ampullary cancer, and programmed cell death ligand 1 expression was positive in 10% of tumor cells and 5% of immune cells. Despite the limited evidence regarding the long-term efficacy of gemcitabine, cisplatin, and durvalumab therapy in ampullary cancer, this case report demonstrates its sustained effectiveness over 18 months in a patient with intestinal-type ampullary cancer.

P=N/A, N=360, Recruiting, Cedars-Sinai Medical Center | Trial completion date: Feb 2026 --> Jun 2026

Gastric-type adenomas are not uncommon among ampullary polyps when carefully examined. They should be distinguished from reactive polyps, because similar to intestinal-type adenomas, they are neoplastic polyps with dysplasia and a risk of recurrence.

P=N/A, N=300, Recruiting, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano

P1/2, N=36, Recruiting, University Hospital, Lille | Trial completion date: Feb 2025 --> Feb 2030 | Trial primary completion date: Feb 2025 --> Feb 2028

P=N/A, N=36, Recruiting, Dartmouth-Hitchcock Medical Center | Trial completion date: May 2026 --> Dec 2026 | Trial primary completion date: Nov 2025 --> Sep 2026

We present a remarkable case of a 69-year-old male with Stage IV pancreaticobiliary-type AC who achieved a complete remission after 45 months of palliative modified FOLFIRINOX chemotherapy (5-fluorouracil, oxaliplatin, leucovorin, irinotecan). These findings raise questions about their potential influence on treatment response and prognosis. This case underscores the need for further investigation into the role of molecular alterations and personalized approaches in managing advanced AC.

P3, N=262, Recruiting, Minia University | Trial completion date: Aug 2026 --> Aug 2028 | Trial primary completion date: Jul 2026 --> Jul 2028

The ORR, DCR, and PFS were comparable to those in the TOPAZ-1 trial. Although limited by its retrospective design and small sample size, this study suggests that GCD therapy is an effective treatment regimen for unresectable biliary tract cancer in real-world clinical practice.

P=N/A, N=170, Recruiting, Insel Gruppe AG, University Hospital Bern | Not yet recruiting --> Recruiting