In recent years, immunotherapy and targeted therapy have been incorporated into cholangiocarcinoma treatment, expanding therapeutic opportunities for affected patients.
What is cholangiocarcinoma?
Cholangiocarcinoma originates in the bile duct cells inside the liver (intrahepatic cholangiocarcinoma), at the hepatic hilum (hilar cholangiocarcinoma), or outside the liver (extrahepatic cholangiocarcinoma).
This tumour typically presents symptoms at advanced, non-surgical stages in most cases, resulting in limited survival rates even today.
Diagnosis requires blood tests, imaging to visualise the tumour and assess its extent, and biopsy.
Surgery and liver transplantation for cholangiocarcinoma
Surgery is the treatment of choice for localised cholangiocarcinoma. Post-surgery, the need for adjuvant chemotherapy is assessed on an individual basis.
For patients with localised non-resectable hilar cholangiocarcinoma, liver transplantation can be a viable option.
At the Clínic Barcelona Comprehensive Cancer Centre (4CB) – driven by Clínic Barcelona, IDIBAPS and UB – all cholangiocarcinoma cases are reviewed by the specialised multidisciplinary committee. This committee, which assesses disease extent and decides treatment, includes all relevant professionals: radiologists, interventional radiologists, surgeons, medical oncologists, radiation oncologists, pathologists, hepatologists, endoscopists, and others.
Immunotherapy and molecular targeted therapy for cholangiocarcinoma
Multiple studies have shown that immunotherapy combined with chemotherapy for advanced, non-surgical cholangiocarcinoma improves survival compared to chemotherapy alone.
Cholangiocarcinoma is also enriched in mutations targetable with personalised therapies, such as IDH1 mutations, FGFR2 fusions, or HER2 overexpression, among others.
At Hospital Clínic, cholangiocarcinoma cases are also reviewed by the Molecular Tumour Board. The goal is to select optimal molecular testing for each patient and not miss actionable alterations. Thus, molecular profiling or NGS of tumour-altered genes is essential upon diagnosis.
Importance of clinical trial participation for cholangiocarcinoma patients
At the Clínic Barcelona Comprehensive Cancer Centre (4CB), offering clinical trial participation is considered a priority treatment option.
Including cholangiocarcinoma patients in clinical trials enables investigation of new therapies that may expand future options against this tumour, while also providing early access to potentially active treatments for patients treated at the hospital.
