The Biliary system comprises gallbladder, bile duct and cells inside the liver and is primarily responsible for storing and releasing bile into duodenum for digestion. Biliary tumors are relatively uncommon and accounts for approximately 2% of all the cancers. There are two types of biliary tumors: hepatocellular carcinoma and cholangiocarcinoma. Hepatocellular carcinoma which refers to tumor that develops within the liver and is more common in nature. Cholangiocarcinoma which is the tumor of liver’s biliary duct and is further categorized into intrahepatic biliary duct tumor and extrahepatic biliary duct tumor based on the occurrence site of the tumor. In the United States the prominent cause of cholangiocarcinoma is primary sclerosing cholangitis (PSC), an inflammatory condition of either intrahepatic or extrahepatic bile ducts. Cholangiocarcinoma tumor is more common in males than females and usually affects patient aged between 5-70 years. Common symptoms of liver tumor include jaundice, abdominal pain, fever, sudden weight loss and itching around liver.
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Approximately 2,000- 3,000 people in the United States suffers from biliary tumor each year. The prevalence of biliary tumor is more common in Asia-pacific and Middle East countries owing to high incidences of parasitic infection of the bile duct. In Great Britain approximately 1,600 people and 400 people are diagnosed with intrahepatic and extrahepatic bile duct tumors each year. The diagnosis of biliary tumor includes CT scan, abdominal ultrasound, MRI, Endoscopy. Blood test in biliary tumor is majorly done for estimating blood count, liver function test and estimation of carcinoembriogenic antigen (CEA) and carbohydrate antigen which usually gets elevated in patient with bile duct tumor. Treatment for biliary tumor depends upon the exact site, size and location of the tumor. Surgical removal of bile duct with the help of laparoscopy is an effective technique if tumor is restricted to gallbladder only. Alternative to laparoscopic operation is an open procedure which includes the removal of complete gall bladder, complete lymph node tissues and some part of the liver tissues. Liver transplant in combination with radiation and chemotherapy has shown positive results as compared to traditional techniques in patients with widely spread tumor and other severe complications.
Major drivers for the global biliary tumor market encompass increasing incidences of gall stones and bile duct stones in obese patient, diabetes, high alcohol consumption and long term infection with hepatitis B or hepatitis C virus. History of biliary tumor in family though increases the chance of developing the disease yet the risk associated with the disease is still very low as the disease is still rare across the globe. Geographically the market is majorly contributed by developed economic countries such as the United States and European countries due to government interventions and support with respect to research and development at university as well as private research centers. Recently in September 2012, Pennsylvania based National Comprehensive Cancer Network received USD 4 million research grant from GlaxoSmithKline to scientifically evaluate the effectivity of drug Trametinib which is a prospecting drug in the treatment of biliary tumor. Some of the other pipelined drugs in global biliary tumor market include Lapatinib, MEK-162 and gemcitabine. Combinational drug under clinical trial include Bevacizumab + Erlotinib, Gemcitabine + Capecitabine and others. Drugs (Trade name) that are prescribed for bile duct tumors include Almito, Mitocin, Mitomycin and Oncocin.
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Some of the key companies and universities in the global biliary tumor market include Novartis AG, GlaxoSmithKline plc, University of Manchester, Southwest Oncology Group and others.
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