Biliary tract cancer treatment: Emerging trends and further prospects

Biliary tract cancer (BTC), including intrahepatic, perihilar, and distal cholangiocarcinoma, as well as gallbladder carcinoma, comprises a heterogeneous group of aggressive malignancies with poor prognosis and limited therapeutic options. Current BTC therapies include surgical resection for early-stage disease, systemic chemotherapy (notably gemcitabine plus cisplatin), molecularly guided targeted therapy, and immunotherapy. However, clinical outcomes remain suboptimal owing to delayed diagnosis, marked tumor heterogeneity, limited available biomarkers, and high postoperative recurrence rates. In this review, we synthesize recent evidence from clinical trials and translational studies on BTC, extract actionable insights for tailored interventions and locoregional therapies, summarize ongoing neoadjuvant therapy trials, and outline practical frameworks for future trial designs and research directions.