Dear Readers,
Welcome to the final edition of CCA News for this season. This end-of-season issue reflects highlights from the 2025 Cholangiocarcinoma (CCA) Summit held in Scottsdale, AZ, where international experts presented leading advances in CCA. As we closed the year, the breadth of progress—from precision systemic therapy and surgery to artificial intelligence (AI) and microbiome science—underscored how quickly our field continues to evolve. Some of the sessions from the CCA Summit are highlighted below.
Targeted therapy frontline debate: Dr Gentry King (University of Washington) emphasized the potential benefits of introducing FGFR2- and HER2-directed therapies earlier in treatment. Dr Shubham Pant (MD Anderson Cancer Center) highlighted the current role of gemcitabine-cisplatin-durvalumab treatment and the need for stronger first-line evidence. Their balanced discussion framed the future direction of precision approaches in biliary tract cancer (BTC).
Microbiome keynote: Dr Nadim Ajami (MD Anderson Cancer Center) highlighted the influence of microbial diversity on immunotherapy response, with emerging biomarker signals in biliary tumors. His presentation reflected growing interest in microbiome-guided precision oncology.
Artificial intelligence: AI continued to reshape hepatobiliary cancer care. Dr Maria El Homsi (Memorial Sloan Kettering Cancer Center) reviewed radiomics and machine-learning applications improving diagnostic accuracy, and Dr Changhoon Yoo (Asan Medical Center) discussed clinical decision tools and decentralized access through AI-supported platforms. Dr Robert Grant (Princess Margaret Cancer Centre) also led a discussion on the applications of AI in CCA- and BTC-focused research.
Medical advances and therapeutic combinations: Dr Sangeeta Goswami (MD Anderson Cancer Center) emphasized the collaboration between immunotherapy and cytoreductive surgery; Dr Marina Baretti (Johns Hopkins) reviewed novel combinations, including DLL4/VEGF- and IDH-directed approaches; and Dr James Harding (Memorial Sloan Kettering Cancer Center) highlighted antibody–drug conjugates and their role in the treatment of patients with CCA.
Clinical trials and precision platforms: Dr Juan Valle (Cholangiocarcinoma Foundation) outlined biomarker-driven platform trials, international collaboration, and decentralized models, emphasizing comprehensive testing and forward-looking trial design, and Dr Peter O’Dwyer (Penn Medicine) discussed the importance of leveraging public–private partnerships and approaches to accelerating research in the CCA and BTC space.
Surgical approaches: Dr Laleh Melstrom (City of Hope) discussed conversion strategies that may render previously unresectable cases operable, and Dr Ryan Fields (University of Rochester Medical Center) reviewed adjuvant and “sandwich” strategies illustrating the growing integration of surgery and systemic therapy.
Multidisciplinary care: Maureen Mork (MD Anderson Cancer Center) emphasized hereditary risk and genetic counseling; Mary Helen Larsen (Memorial Sloan Kettering Cancer Center) highlighted oncology nursing and care coordination; and Sarah Johnston (NYU Langone Health) addressed nutrition and treatment tolerance, reinforcing the central role of multidisciplinary care.
Histotripsy crossfire debate: Dr Kevin Burns (Providence Mission Hospital) described encouraging early outcomes with histotripsy as a novel locoregional therapy, and Dr Brock Hewitt (NYU Langone Health) emphasized uncertainties and the need for further validation and careful patient selection.
As we conclude this issue—and this season—I want to thank all contributors, investigators, clinical teams, and patients whose innovation and commitment continue to guide progress in CCA. On behalf of the editorial team, I wish everyone a wonderful, peaceful, and healthy holiday season.
Warm regards,
Milind Javle, MD
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