Moving forward in the treatment of cholangiocarcinoma

Table 1 Surgical ongoing trials for cholangiocarcinoma

CCA Type	Domain	Trial name	Summary
iCCA/pCCA	Hepatic venous deprivation	NCT03841305	Randomized trial of portal vein embolization vs hepatic venous deprivation. Primary endpoint: future liver remnant at 3 wk
iCCA	Liver transplantation	NCT02878473	Liver transplantation for early (< 3 cm) iCCA. Single group assignment
iCCA	Liver transplantation	NCT04556214	Liver transplantation for stable (> 6 mo), advanced (unresectable) iCCA. Single group assignment
iCCA	Liver transplantation	NCT04195503	Liver transplantation for stable (> 6 mo), advanced (unresectable) iCCA. Single group assignment
pCCA	Lymphadenectomy	ChiCTR1800015688	Randomized trial of extended vs regional lymphadenectomy for resectable pCCA. Primary endpoint: overall survival
pCCA	Liver transplantation	NCT02232932	Randomized trial of liver transplantation vs resection for resectable pCCA (< 3 cm). Primary endpoint: overall survival at 5 yr

iCCA: Intrahepatic cholangiocarcinoma; pCCA: Perihilar cholangiocarcinoma.

Table 2 The new systemic, surgical and combined approaches to cholangiocarcinoma

	Approaches
Systemic therapy	(1) Overcoming chemoresistance; (2) Genetic aberration targeted therapy; (3) Immune checkpoint inhibitors; and (4) Neuroendocrine modulation of cancer growth
Surgical therapy	(1) Liver venous deprivation; (2) Minimally invasive surgery; and (3) Liver transplantation
Combined therapy	Liver transplantation or surgical resection after radiotherapy and/or neoadjuvant treatment