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Cholangiocarcinoma starts in the bile ducts, the tubes that carry bile from the liver to the small intestine. It is grouped with gallbladder cancer as biliary tract cancer and divided by location: intrahepatic (inside the liver), perihilar (where the ducts leave the liver), and distal (closer to the intestine). Symptoms, usually yellowing of the skin and eyes, itching, pale stools, dark urine, and weight loss, tend to appear late. Known risk factors include primary sclerosing cholangitis, bile duct stones and cysts, chronic liver disease, and in parts of Asia liver fluke infection, but most people have none of them.
Surgery is the only route to cure, and it is possible for a minority. For advanced disease the standard first treatment is chemotherapy with immunotherapy, and testing the tumor's genes is now routine because FGFR2, IDH1, and HER2 changes each have targeted drugs. Overall five year survival is around 1 in 10. Cancer that starts in the main liver cells is a different disease, covered on our liver cancer page.
New to research? Read how clinical trials for cancer work.
Targeted therapy trials. New or combined drugs for FGFR2, IDH1, HER2, and other alterations, including targeted drugs combined with immunotherapy.
Antibody drug conjugate trials. Chemotherapy delivered by antibody, tested across biliary tract cancers.
First line combination trials. New drugs added to standard chemotherapy plus immunotherapy.
Liver directed trials. Hepatic artery infusion pumps and radiation for cancer confined to the liver.
Immunotherapy and vaccine trials. Early phase studies of cell based vaccines and new immune approaches.
Surgery and biology studies. Chemotherapy before or after surgery, and tissue studies into why intrahepatic cholangiocarcinoma is rising.
Most trials enroll adults with advanced or metastatic biliary tract cancer that cannot be removed by surgery, split by whether they have had prior chemotherapy. Targeted trials require a tumor test showing a specific alteration, so it is worth asking for comprehensive genomic testing at diagnosis if it has not been done. Adequate liver function is a common requirement, and a blocked bile duct usually has to be relieved with a stent first. Because the cancer is rare, many trials accept patients from across the country, and some help with travel. Eligibility always varies by study.
Only when it can be completely removed by surgery, which is possible for a minority because it is usually found late. For advanced disease, treatment extends life and controls symptoms, and targeted drugs have improved outcomes for people whose tumors carry specific alterations.
Resectable. Removable by surgery, the only route to cure. Trials test chemotherapy before and after the operation.
Locally advanced. Confined to the area but not removable. Liver directed and combination trials enroll here.
Metastatic. Spread to distant sites. Most drug trials recruit here, sorted by molecular alteration and prior treatment.
By location. Intrahepatic, perihilar, and distal tumors differ in biology and surgery; some trials enroll only one location.
Identify your trial. Use the filters and search "cholangiocarcinoma," "bile duct," and "biliary tract," since listings use all three.
Select your preferred location. Enter your city or state, then widen the radius; many sponsors help with travel to specialist centers.
Explore study details. Click "Learn More" for the molecular target required, prior treatment rules, and liver function limits.
Complete the health profile. Click "Get started" to begin the 5-step application. Have ready the location and stage of your cancer, your tumor genomic test results, and the treatments you have had.
Submit the application. A clinical trial coordinator reviews it and contacts you. Nothing is decided until informed consent, and participation is voluntary at every step.