Notable Takeaways From the 2024 Cholangiocarcinoma Foundation Annual Conference

Dear Readers,

In this June 2024 issue of CCA News, we cover presentations from the 2024 Cholangiocarcinoma (CCA) Foundation Annual Conference, which took place in Salt Lake City, UT, April 17-19.

Pedro Rodrigues, PhD, from Portugal, presented exciting work on genomic, proteomic, and metabolomic biomarkers for detecting CCA in cases with primary sclerosing cholangitis and differentiating it from hepatocellular carcinoma using liquid biopsy platforms.

Liquid biopsy platforms have also been integral in understanding resistance mechanisms to targeted therapies, including fibroblast growth factor receptor (FGFR) inhibitors, as described by Funda Meric-Bernstam, MD, from the MD Anderson Cancer Center, Houston, TX. N550 and V565 are among the most common acquired mutations in the FGFR pathway, and novel agents, including tinengotinib and KN-3248, have shown efficacy in this resistant setting.

Sudha Kodali, MD, MSPH, from Houston Methodist Hospital, Houston, TX, presented exciting new data on liver transplantation for intrahepatic CCA: a new modality in this disease that has yielded promising early results. Three fascinating sessions on artificial intelligence (AI) highlighted its role in CCA management.

Julius Chapiro, MD, PhD, from the Yale School of Medicine, New Haven, CT, highlighted deep learning techniques for accurately diagnosing hepatic lesions on contrast-enhanced magnetic resonance imaging. The pathologic diagnosis of CCA and its distinction from other metastatic lesions is complicated, and AI-based algorithms can be used purposefully on hematoxylin and eosin-stained whole-slide images. Mrinal Shekhar, PhD, from the Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA, noted that active machine learning accelerates virtual screenings for candidates while optimizing desired drug properties.

These methodologies are expected to accelerate early detection, diagnosis, and novel therapeutics for CCA. Robin Katie Kelley, MD, from the University of California, San Francisco (UCSF), presented data from various databases regarding the prevalence of germline mutations in biliary tract cancer (BTC). While germline testing is now National Comprehensive Cancer Network–approved in pancreatic cancer, it is not valid in BTC. These mutations have prognostic and predictive relevance for DNA damage repair and checkpoint inhibitors.

Finally, congratulations to Robin Katie Kelley and Tim F. Greten, MD, from the National Cancer Institute, Bethesda, MD, on being awarded the Bachrach Family Foundation Innovation Grant to study the molecular and immunologic mechanisms of resistance in CCA.

Yours truly,

Milind Javle, MD