Dr. Javle reviewed FGFR inhibitor sequencing in cholangiocarcinoma. Newer agents improved responses (35%→60%), overcame resistance, and support molecular-guided care with FGFR2-targeted ADCs in development.

Dr. Borad reviewed IDH1-mutant cholangiocarcinoma. Ivosidenib improved PFS with low toxicity but modest benefit. Resistance drives research into combination therapies and new targeted strategies.

Dr. Kim reviewed HER2-targeted therapy in biliary tract cancer. HER2 IHC3+ predicts best response, with T-DXd and zanidatamab showing strong outcomes. Ongoing studies aim to optimize sequencing and combinations.

Dr. Kim highlighted for biomarker-negative metastatic BTC, FOLFOX remains standard second-line therapy with modest benefit. Emerging agents, including bispecific antibodies and novel TKIs, show promise in ongoing trials.

The panel highlighted advances in cholangiocarcinoma, including FGFR and IDH inhibitors, emerging ADCs, bispecifics, and RAS-targeted agents, emphasizing biomarker-driven, multidisciplinary care.