Dr. Ahn on the Increased Understanding of Cholangiocarcinoma

Daniel H. Ahn, DO, consultant, Division of Hematology/Oncology, Department of Internal Medicine, assistant professor of medicine, Mayo Clinic, discusses the increased understanding of cholangiocarcinoma.

The field’s understanding of cholangiocarcinoma has changed significantly in the past 5 years, particularly with regard to the genetics of the disease, Ahn says. For example, 3 anatomically and genomically distinct subtypes of cholangiocarcinoma have been identified. Moreover, some of the common mutations identified in this disease are actionable, Ahn adds.

In the past 2 years, the FGFR2 inhibitors pemigatinib (Pemazyre) and infigratinib (Truseltiq), as well as the IDH1 inhibitor ivosidenib (Tibsovo) have been granted regular or accelerated approval by the FDA for use in patients with cholangiocarcinoma. With these new targeted options available, up-front and repeat molecular testing is critical, Ahn explains.

Additionally, a rising incidence of cholangiocarcinoma has been observed. This is likely because of several factors, including increased understanding of the disease, improved diagnostic criteria for cholangiocarcinomas that would have been previously diagnosed as cancers of unknown primary origin, and a potential increase in previously unknown risk factors, Ahn concludes.