Clinical and molecular characteristics of early-onset pancreatic and biliary cancers

Biliary tract cancer and pancreatic cancer are aggressive malignancies, typically diagnosed in patients >50 years of age. Lately, <50 years of age has been rising, presenting unique challenges and clinical features that distinguish them from late-onset cases. Here, we review the clinical, biological, and molecular characteristics of early-onset biliary tract cancer and pancreatic cancer and compare them with their late-onset counterparts. We also examine treatment patterns, efficacy, and the potential role of targeted therapies, as well as the potential psychological and social effects on younger patients, with particular emphasis on fertility. We therefore offer insights into the unique challenges and therapeutic strategies in managing early-onset disease.