Cholangiocarcinoma targeted therapy widens past chemotherapy
FGFR2 inhibitor maturity, IDH1 inhibitor use, HER2-targeted therapy entry, and IO combinations are restructuring biliary tract cancer management.
Cholangiocarcinoma was a gemcitabine-cisplatin-only category for years. FGFR2 inhibitors (pemigatinib, infigratinib, futibatinib) carry approvals in FGFR2-fusion-positive intrahepatic cholangiocarcinoma, ivosidenib provides an IDH1-mutant option, trastuzumab deruxtecan extends ADC reach into HER2-amplified biliary tract cancer, and IO plus chemotherapy is now first-line standard. The biomarker-pathway investment (FGFR2 fusions, IDH1 mutations, HER2 amplification, MSI status, BRCA, BRAF, NTRK fusions) is now layered.
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