Systemic therapy of biliary tract cancer: The road to personalised strategies.

Targeted therapies for intrahepatic cholangiocarcinoma with FGFR2 fusions/rearrangements show meaningful response rates and durable disease control.

• Why it matters: Biliary tract cancers have poor prognoses, and personalized treatment approaches are needed to improve outcomes, especially for molecularly defined subgroups.
• What they did: The review discusses established chemo-immunotherapy, targeted therapies like pemigatinib, futibatinib, and ivosidenib, as well as promising HER2-directed and tumour-agnostic therapies, highlighting current clinical trials and diagnostic challenges.
• The result: Advances in targeted treatments and diagnostics are broadening therapeutic options, but barriers such as heterogeneous biomarker testing and resistance biology underscore the need for optimized diagnostics and innovative trial designs to enable personalized care.