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A carcinoma that arises from the intrahepatic biliary tree (intrahepatic cholangiocarcinoma) or from the junction, or adjacent to the junction, of the right and left hepatic ducts (hilar cholangiocarcinoma). Grossly, the malignant lesions are solid, nodular, and grayish. Morphologically, the vast majority of cases are adenocarcinomas. Signs and symptoms include malaise, weight loss, right upper quadrant abdominal pain, and night sweats. Early detection is difficult and the prognosis is generally poor.
Biomarker and diagnostic research for cholangiocarcinoma has been reported in the published literature.
2 FDA-approved treatments are available for cholangiocarcinoma, including IVOSIDENIB (TIBSOVO, approved 2018) and PEMIGATINIB (PEMAZYRE, approved 2020). An additional 27 compounds hold orphan drug designation.
Brand Name | Generic Name | Mechanism | Approved | Market Status |
|---|---|---|---|---|
Estimated prevalence: 1-9 in 100,000 (Uncommon).
349 clinical trials registered, 162 recruiting. Interventions under study include drug therapy, procedural interventions, other interventions, and biologic therapy. Pipeline includes 4 PHASE4, 9 PHASE3, 132 PHASE2. Research is sponsored by a mix of industry and academic institutions.
NCT ID | Title | Phase | Sponsor | Status |
|---|---|---|---|---|
[NCT03364530](https://clinicaltrials.gov/study/NCT03364530) |
Data assembled from 5 of 12 sources · Last updated Sep 19, 2026, 9:39 PM UTC
Patient Advocacy Groups (PAGs) provide support, resources, and community for patients and caregivers.
European rare disease database
Genetic and Rare Diseases Info Center
PEMAZYRE |
PEMIGATINIB |
— |
2020 |
Available |
TIBSOVO | IVOSIDENIB | — | 2018 | Available |
The following drugs have received orphan drug designation from the FDA for cholangiocarcinoma. Orphan designation reflects regulatory interest and does not indicate approval for treatment.
Brand Name | Generic Name | Sponsor | Designated | Exclusivity End | Designation Status |
|---|---|---|---|---|---|
antibody-drug conjugate (ADC) consisting of a humanized anti-trophoblast cell surface antigen-2 (TROP2) antibody (R4702) and a protease-cleavable linker-payload N-PM-0022 (BCN-GGVA-PAB(PEG24)-exatecan) | antibody-drug conjugate (ADC) consisting of a humanized anti-trophoblast cell surface antigen-2 (TROP2) antibody (R4702) and a protease-cleavable linker-payload N-PM-0022 (BCN-GGVA-PAB(PEG24)-exatecan) | OBI Pharma USA Inc. | 2025 | — | Designated |
butaselen | butaselen | Shanghai Yuanxi Medicine Corp. | 2024 | — | Designated |
Chimeric virus with a double-stranded DNA genome comprised of elements of 6 human vaccinia pox viruses with a human sodium-iodide symporter (hNIS) transgene | Chimeric virus with a double-stranded DNA genome comprised of elements of 6 human vaccinia pox viruses with a human sodium-iodide symporter (hNIS) transgene | Imugene Limited | 2024 | — | Designated |
certepetide | certepetide | Lisata Therapeutics, Inc | 2024 | — | Designated |
N-[5-(2,3-Dihydrobenzo[b][1,4]dioxine-6-carboxamido)-2-fluorophenyl]-2-[(4-ethylpiperazin-1-yl)methyl]quinoline-6-carboxamide | N-[5-(2,3-Dihydrobenzo[b][1,4]dioxine-6-carboxamido)-2-fluorophenyl]-2-[(4-ethylpiperazin-1-yl)methyl]quinoline-6-carboxamide | Nuvectis Pharma, Inc. | 2023 | — | Designated |
recombinant human IL12/15-PDL1B HSV-1 oncolytic virus injection | recombinant human IL12/15-PDL1B HSV-1 oncolytic virus injection | Virogin Biotech Canada Ltd | 2023 | — | Designated |
a humanized immunoglobulin IgG1 antibody with a kappa light chain (LC) which has high selectivity and specificity for cancer-specific plectin | a humanized immunoglobulin IgG1 antibody with a kappa light chain (LC) which has high selectivity and specificity for cancer-specific plectin | ZielBio Incorporated | 2022 | — | Designated |
N-(6-(2,6-dichloro-3,5-dimethoxyphenyl)-1H-pyrazolo[3,4-b]pyridin-3-yl)-4-(3,3-dimethylpiperazin-1-yl)benzamide hydrochloride | N-(6-(2,6-dichloro-3,5-dimethoxyphenyl)-1H-pyrazolo[3,4-b]pyridin-3-yl)-4-(3,3-dimethylpiperazin-1-yl)benzamide hydrochloride | 3D Medicines (Beijing) Co., Ltd | 2022 | — | Designated |
ezurpimtrostat | ezurpimtrostat | Genfit SA | 2022 | — | Designated |
N-(4-(4-amino-5-(3-fluoro-4-((4-methylpyrimidin-2-yl)oxy)phenyl)-7-methyl-7H-pyrrolo[2,3-d]pyrimidin-6-yl)phenyl)methacrylamide hydrochloride | N-(4-(4-amino-5-(3-fluoro-4-((4-methylpyrimidin-2-yl)oxy)phenyl)-7-methyl-7H-pyrrolo[2,3-d]pyrimidin-6-yl)phenyl)methacrylamide hydrochloride | Elevar Therapeutics, Inc. | 2022 | — | Designated |
Recombinant human interleukin-15/IL-15 receptor alpha complex with linked integrin binding motif | Recombinant human interleukin-15/IL-15 receptor alpha complex with linked integrin binding motif | BJ Bioscience Inc. | 2021 | — | Designated |
gavocabtagene autoleucel (gavo-cel) | gavocabtagene autoleucel (gavo-cel) | TCR2 Therapeutics, Inc., a wholly owned | 2021 | — | Withdrawn |
gunagratinib | gunagratinib | InnoCare Pharma Inc. | 2021 | — | Withdrawn |
4-(5-(2-chlorophenyl)-3-methyl-2,10-dihydropyrazolo[4,3-b] pyrido[4,3-e][1,4]diazepin-8-yl) morpholine | 4-(5-(2-chlorophenyl)-3-methyl-2,10-dihydropyrazolo[4,3-b] pyrido[4,3-e][1,4]diazepin-8-yl) morpholine | TransThera Sciences (Nanjing), Inc. | 2019 | — | Designated |
Truseltiq | infigratinib | QED Therapeutics, Inc. | 2019 | 2023 | Withdrawn |
4-amino-1-[(2R,3S,4S,5R)-3-fluoro-4-hydroxy-5-(hydroxymethyl)tetrahydrothiophen-2-yl] pyrimidin-2(1H)-one | 4-amino-1-[(2R,3S,4S,5R)-3-fluoro-4-hydroxy-5-(hydroxymethyl)tetrahydrothiophen-2-yl] pyrimidin-2(1H)-one | FUJIFILM Pharmaceutical U.S.A., Inc. | 2018 | — | Designated |
fimaporfin | fimaporfin | PCI Biotech AS | 2017 | — | Withdrawn |
Redaporfin | Redaporfin | Luzitin, S.A. | 2017 | — | Designated |
liposomal oxaliplatin | liposomal oxaliplatin | KC Specialty Therapeutics, LLC | 2017 | — | Designated |
4-pyridinylmethyl 3(4-chlorophenyl)adamantine carboxamide | 4-pyridinylmethyl 3(4-chlorophenyl)adamantine carboxamide | RedHill Biopharma Ltd. | 2017 | — | Designated |
Silmitasertib | Silmitasertib | Senhwa Biosciences, Inc. | 2016 | — | Designated |
6-methoxy-3-(3',4',5'-trimethoxybenzoyl) indole | 6-methoxy-3-(3',4',5'-trimethoxybenzoyl) indole | SynCore Biotechnology Co. Ltd. | 2016 | — | Withdrawn |
gemcitabine | gemcitabine | InnoPharmax, Inc. | 2016 | — | Designated |
(R)-6-(2-fluorophenyl)-N-(3-(2-((2-methoxyethyl)amino)ethyl)phenyl)-5,6-dihydrobenzo[h]quinazolin-2-amine dihydrochloride | (R)-6-(2-fluorophenyl)-N-(3-(2-((2-methoxyethyl)amino)ethyl)phenyl)-5,6-dihydrobenzo[h]quinazolin-2-amine dihydrochloride | Basilea Pharmaceutical International Ltd. | 2015 | — | Designated |
melphalan | melphalan | Delcath Systems, Inc. | 2015 | — | Designated |
(+/-)-cis-3-(4-hydroxyphenyl)-4-(4-methoxyphenyl)-3,4-dihydro-2H-cromen-7-ol | (+/-)-cis-3-(4-hydroxyphenyl)-4-(4-methoxyphenyl)-3,4-dihydro-2H-cromen-7-ol | Marshall Edwards, Inc. | 2008 | — | Withdrawn |
Porfimer sodium | Porfimer sodium | Concordia Laboratories, Inc., Sarl | 2004 | — | Designated |
gemcitabine is referenced in active clinical trials for cholangiocarcinoma (designated 2016).
Gene therapy approaches for cholangiocarcinoma have been reported in the published literature.
349 trials found
Hepatic Arterial Infusion of Gemcitabine-oxaliplatin for Second-line Therapy in Non-metastatic Unresectable Intra-hepatic Cholangiocarcinoma |
PHASE2 |
University Hospital, Montpellier |
RECRUITING |
[NCT05714124](https://clinicaltrials.gov/study/NCT05714124) | Liver Embolization Approaches for Tumor Management | — | IRCCS San Raffaele | RECRUITING |
[NCT04421820](https://clinicaltrials.gov/study/NCT04421820) | BOLD-100 in Combination With FOLFOX for the Treatment of Advanced Solid Tumours | PHASE1 | Bold Therapeutics, Inc. | RECRUITING |
[NCT06850753](https://clinicaltrials.gov/study/NCT06850753) | En Bloc Resection of the Liver and Pancreas With a "Non-touch" Technique Followed by Liver Transplantation to Improve the Overall Survival in Patients With Non-resectable Hilar Cholangiocarcinoma Beyond the Mayo Clinic Transplant Criteria | NA | Oslo University Hospital | RECRUITING |
[NCT06914648](https://clinicaltrials.gov/study/NCT06914648) | The Dragon PLC Trial (DRAGON-PLC) | NA | Maastricht University | RECRUITING |
500 publications have been identified in PubMed for cholangiocarcinoma. Research spans Review / Meta-Analysis (28%), Basic Science / Preclinical (27%), and Epidemiology / Natural History (13%).
Research Type | Count | % of Total |
|---|---|---|
Research summaries | 139 | 28% |
Laboratory research | 136 | 27% |
Disease patterns and progression | 63 | 13% |
Testing and diagnosis research | 58 | 12% |
Clinical study results | 47 | 9% |
New treatment approaches | 31 | 6% |
Patient case studies | 21 | 4% |
Other research | 5 | 1% |
Liu H (2026). [PMID: 40683603](https://pubmed.ncbi.nlm.nih.gov/40683603/). *J Hepatol*. [Basic Science / Preclinical]
Wan J (2026). [PMID: 41460204](https://pubmed.ncbi.nlm.nih.gov/41460204/). *Clin Cancer Res*. [Basic Science / Preclinical]
Wang S (2026). [PMID: 41611833](https://pubmed.ncbi.nlm.nih.gov/41611833/). *Sci Rep*. [Diagnostic / Biomarker]
Wang J (2026). [PMID: 41354626](https://pubmed.ncbi.nlm.nih.gov/41354626/). *Adv Sci (Weinh)*. [Basic Science / Preclinical]
Qiao Y (2026). [PMID: 41332325](https://pubmed.ncbi.nlm.nih.gov/41332325/). *Adv Sci (Weinh)*. [Gene Therapy / Novel Therapeutics]
Cai D (2026). [PMID: 41786282](https://pubmed.ncbi.nlm.nih.gov/41786282/). *Cancer Lett*. [Basic Science / Preclinical]
Lin Y (2026). [PMID: 41916296](https://pubmed.ncbi.nlm.nih.gov/41916296/). *Cell Rep Med*. [Basic Science / Preclinical]
Zen Y (2026). [PMID: 41988855](https://pubmed.ncbi.nlm.nih.gov/41988855/). *Histopathology*. [Review / Meta-Analysis]
Kubota N (2026). [PMID: 41770625](https://pubmed.ncbi.nlm.nih.gov/41770625/). *Cancer Sci*. [Basic Science / Preclinical]
Ellis H (2026). [PMID: 41571046](https://pubmed.ncbi.nlm.nih.gov/41571046/). *Ann Oncol*. [Gene Therapy / Novel Therapeutics]
AI-curated news mentioning cholangiocarcinoma
Updated Aug 28, 2026
A case study highlights the cholangioblastic variant of intrahepatic cholangiocarcinoma in a young adult with situs inversus totalis. This discovery adds to the understanding of rare cancer presentations and their potential associations.
Research from the GLOBAL-BTC registry reveals that chronic liver disease correlates with earlier-stage diagnosis of cholangiocarcinoma and better prognosis. These findings could influence future screening and treatment strategies for patients.
A case study highlights cholangiocarcinoma in a 33-year-old male with CD40L deficiency and pre-papillary bile duct stenosis. This research contributes to understanding the potential link between genetic deficiencies and bile duct cancers.
FDA approves Bizengri (zenocutuzumab-zbco) for treating NRG1 fusion-positive cholangiocarcinoma, marking the seventh approval under the National Priority Voucher Pilot Program. This ultra-rare cancer affects the bile ducts and has limited treatment options.