Cholangiocarcinoma 2026: status quo, unmet needs and priorities
6
Issued Date
2026-01-01
Resource Type
ISSN
17595045
eISSN
17595053
Scopus ID
2-s2.0-105025892556
Pubmed ID
41372578
Journal Title
Nature Reviews Gastroenterology and Hepatology
Volume
23
Issue
1
Start Page
65
End Page
96
Rights Holder(s)
SCOPUS
Bibliographic Citation
Nature Reviews Gastroenterology and Hepatology Vol.23 No.1 (2026) , 65-96
Suggested Citation
Banales J.M., Rodrigues P.M., Affò S., Andersen J.B., Aspichueta P., Boulter L., Bridgewater J., Calvisi D.F., Cardenas A., Cardinale V., Carpino G., Coulouarn C., Dopazo C., Edeline J., Fabris L., Folseraas T., Forner A., Goeppert B., Heikenwalder M., Kendall T.J., Khan S.A., Klümpen H.J., Koerkamp B.G., Lamarca A., Lindsey S., Lleo A., Luedde T., Macias R.I.R., Morement H., Nault J.C., Olaizola P., Perugorria M.J., Raggi C., Rimassa L., Saborowski A., Valle J.W., Vithayathil M., Vogel A., Braconi C., Lopez-Lopez V., Megdanova V., Cillo U., Mahmood U., Patel T., Mocan T., Greten T.F., Tian T.V., Gruenberger T., Macarulla T., Pereira S.P., Chan S.L., Roessler S., Caruso S., Jirawatnotai S., Vicent S., Maithel S.K., Gradilone S., Xue R., Kelley R.K., Montal R., Shroff R., Guest R., Milkiewicz P., Olthof P.B., Acedo P., Padilla-Machaca P.M., Scatton O., Detry O., Azad N., Bardeesy N., Verstegen M., Niger M., Meneses-Medina M.I., El-Kassas M., Bouattour M., Borad M., Komuta M., Evert M., Avila M.A., Mandea M., Colombo M., Salati M., Cadamuro M., Peck-Radosavljevic M., Strazzabosco M., Ponz M., Deutsch M.M., Rengo M., Marzioni M., Carbone M., McNamara M.G., Bujanda L., Maroni L., Da Fonseca L.G., Izquierdo-Sanchez L., Goff L., Heij L., Zieniewicz K., Kupcinskas J., Busquets J. Cholangiocarcinoma 2026: status quo, unmet needs and priorities. Nature Reviews Gastroenterology and Hepatology Vol.23 No.1 (2026) , 65-96. 96. doi:10.1038/s41575-025-01153-w Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/114676
Title
Cholangiocarcinoma 2026: status quo, unmet needs and priorities
Author(s)
Banales J.M.
Rodrigues P.M.
Affò S.
Andersen J.B.
Aspichueta P.
Boulter L.
Bridgewater J.
Calvisi D.F.
Cardenas A.
Cardinale V.
Carpino G.
Coulouarn C.
Dopazo C.
Edeline J.
Fabris L.
Folseraas T.
Forner A.
Goeppert B.
Heikenwalder M.
Kendall T.J.
Khan S.A.
Klümpen H.J.
Koerkamp B.G.
Lamarca A.
Lindsey S.
Lleo A.
Luedde T.
Macias R.I.R.
Morement H.
Nault J.C.
Olaizola P.
Perugorria M.J.
Raggi C.
Rimassa L.
Saborowski A.
Valle J.W.
Vithayathil M.
Vogel A.
Braconi C.
Lopez-Lopez V.
Megdanova V.
Cillo U.
Mahmood U.
Patel T.
Mocan T.
Greten T.F.
Tian T.V.
Gruenberger T.
Macarulla T.
Pereira S.P.
Chan S.L.
Roessler S.
Caruso S.
Jirawatnotai S.
Vicent S.
Maithel S.K.
Gradilone S.
Xue R.
Kelley R.K.
Montal R.
Shroff R.
Guest R.
Milkiewicz P.
Olthof P.B.
Acedo P.
Padilla-Machaca P.M.
Scatton O.
Detry O.
Azad N.
Bardeesy N.
Verstegen M.
Niger M.
Meneses-Medina M.I.
El-Kassas M.
Bouattour M.
Borad M.
Komuta M.
Evert M.
Avila M.A.
Mandea M.
Colombo M.
Salati M.
Cadamuro M.
Peck-Radosavljevic M.
Strazzabosco M.
Ponz M.
Deutsch M.M.
Rengo M.
Marzioni M.
Carbone M.
McNamara M.G.
Bujanda L.
Maroni L.
Da Fonseca L.G.
Izquierdo-Sanchez L.
Goff L.
Heij L.
Zieniewicz K.
Kupcinskas J.
Busquets J.
Rodrigues P.M.
Affò S.
Andersen J.B.
Aspichueta P.
Boulter L.
Bridgewater J.
Calvisi D.F.
Cardenas A.
Cardinale V.
Carpino G.
Coulouarn C.
Dopazo C.
Edeline J.
Fabris L.
Folseraas T.
Forner A.
Goeppert B.
Heikenwalder M.
Kendall T.J.
Khan S.A.
Klümpen H.J.
Koerkamp B.G.
Lamarca A.
Lindsey S.
Lleo A.
Luedde T.
Macias R.I.R.
Morement H.
Nault J.C.
Olaizola P.
Perugorria M.J.
Raggi C.
Rimassa L.
Saborowski A.
Valle J.W.
Vithayathil M.
Vogel A.
Braconi C.
Lopez-Lopez V.
Megdanova V.
Cillo U.
Mahmood U.
Patel T.
Mocan T.
Greten T.F.
Tian T.V.
Gruenberger T.
Macarulla T.
Pereira S.P.
Chan S.L.
Roessler S.
Caruso S.
Jirawatnotai S.
Vicent S.
Maithel S.K.
Gradilone S.
Xue R.
Kelley R.K.
Montal R.
Shroff R.
Guest R.
Milkiewicz P.
Olthof P.B.
Acedo P.
Padilla-Machaca P.M.
Scatton O.
Detry O.
Azad N.
Bardeesy N.
Verstegen M.
Niger M.
Meneses-Medina M.I.
El-Kassas M.
Bouattour M.
Borad M.
Komuta M.
Evert M.
Avila M.A.
Mandea M.
Colombo M.
Salati M.
Cadamuro M.
Peck-Radosavljevic M.
Strazzabosco M.
Ponz M.
Deutsch M.M.
Rengo M.
Marzioni M.
Carbone M.
McNamara M.G.
Bujanda L.
Maroni L.
Da Fonseca L.G.
Izquierdo-Sanchez L.
Goff L.
Heij L.
Zieniewicz K.
Kupcinskas J.
Busquets J.
Author's Affiliation
Universidade de São Paulo
University College London
Imperial College London
University of California, San Francisco
Sapienza Università di Roma
Peking University
Sorbonne Université
Massachusetts General Hospital
The University of Edinburgh
Yale University
Universiteit van Amsterdam
Johns Hopkins University School of Medicine
Università degli Studi di Padova
Yale School of Medicine
Universitat de Barcelona
University of Glasgow
Chinese University of Hong Kong
Eberhard Karls Universität Tübingen
University of Bern
Emory University School of Medicine
Erasmus MC
National Cancer Institute (NCI)
National and Kapodistrian University of Athens
Universidad del Pais Vasco
Hannover Medical School
Vanderbilt University Medical Center
Hôpital Universitaire Pitié Salpêtrière
Université de Rennes
Hospital Clínic de Barcelona
German Cancer Research Center
Universitätsklinikum Heidelberg
Universität Regensburg
Università Politecnica delle Marche
Universidad de Salamanca
University of Arizona College of Medicine – Tucson
Medical University of Warsaw
Universitätsklinikum Essen
Cancer Research UK
Rikshospitalet-Radiumhospitalet HF
Universitatea Babeș-Bolyai
Institut d'Investigacions Biomèdiques August Pi i Sunyer - IDIBAPS
Princess Margaret Cancer Centre
Université Paris-Est Créteil Val de Marne
Universidad de Navarra
University Sorbonne Paris Nord
Mayo Clinic in Jacksonville, Florida
Faculty of Biology, Medicine and Health
Hospital Universitari de Bellvitge
University College London Hospitals NHS Foundation Trust
Universitatea de Medicina si Farmacie Carol Davila din Bucuresti
Universitätsklinikum Düsseldorf
Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
Humanitas Research Hospital
Toronto General Hospital
Ikerbasque, Basque Foundation for Science
Centre Hospitalier Universitaire de Liege
Capital University
Siriraj Hospital
Imperial College Healthcare NHS Trust
The Christie NHS Foundation Trust
Clínica Universidad de Navarra
Azienda Ospedale Università Padova
Pomeranian Medical University in Szczecin
UCL Cancer Institute
Hôpital Beaujon
Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas
Instituto Nacional de la Nutrición Salvador Zubiran
Asst Grande Ospedale Metropolitano Niguarda
Universidad Nacional Mayor de San Marcos
Università degli Studi di Firenze, Facoltà di Medicina e Chirurgia
Humanitas University
Hospital Clínico Universitario Virgen de la Arrixaca
Azienda Ospedaliero - Universitaria di Modena
International University of Health and Welfare
Lietuvos Sveikatos Mokslų Universitetas
Facoltà di Farmacia e Medicina
Facoltà di Medicina e Odontoiatria
Erasmus MC Cancer Institute
MRC Human Genetics Unit
Hospital Universitario Fundación Jiménez Díaz
University Hospital Alexandrovska
The Cima Universidad de Navarra
Biogipuzkoa Health Research Institute
Hospital Arnau de Vilanova
Vall d‘Hebron Institut de Oncologia
MRC Centre for Inflammation Research
The Hormel Institute
Sigmund Freud Privatuniversitat Wien
Beatson West of Scotland Cancer Centre
Biotech Research & Innovation Centre
Centre Eugène Marquis Rennes
Erasmus MC Transplant Institute
CRUK Scotland Institute
Klinikum Klagenfurt am Woerthersee
Cholangiocarcinoma Foundation
Biobizkaia Health Research Institute
The Cholangiocarcinoma Charity
RKH Klinikum
EASL International Liver Foundation
12Mayo Clinic Comprehensive Cancer Center
University College London
Imperial College London
University of California, San Francisco
Sapienza Università di Roma
Peking University
Sorbonne Université
Massachusetts General Hospital
The University of Edinburgh
Yale University
Universiteit van Amsterdam
Johns Hopkins University School of Medicine
Università degli Studi di Padova
Yale School of Medicine
Universitat de Barcelona
University of Glasgow
Chinese University of Hong Kong
Eberhard Karls Universität Tübingen
University of Bern
Emory University School of Medicine
Erasmus MC
National Cancer Institute (NCI)
National and Kapodistrian University of Athens
Universidad del Pais Vasco
Hannover Medical School
Vanderbilt University Medical Center
Hôpital Universitaire Pitié Salpêtrière
Université de Rennes
Hospital Clínic de Barcelona
German Cancer Research Center
Universitätsklinikum Heidelberg
Universität Regensburg
Università Politecnica delle Marche
Universidad de Salamanca
University of Arizona College of Medicine – Tucson
Medical University of Warsaw
Universitätsklinikum Essen
Cancer Research UK
Rikshospitalet-Radiumhospitalet HF
Universitatea Babeș-Bolyai
Institut d'Investigacions Biomèdiques August Pi i Sunyer - IDIBAPS
Princess Margaret Cancer Centre
Université Paris-Est Créteil Val de Marne
Universidad de Navarra
University Sorbonne Paris Nord
Mayo Clinic in Jacksonville, Florida
Faculty of Biology, Medicine and Health
Hospital Universitari de Bellvitge
University College London Hospitals NHS Foundation Trust
Universitatea de Medicina si Farmacie Carol Davila din Bucuresti
Universitätsklinikum Düsseldorf
Fondazione IRCCS Istituto Nazionale dei Tumori, Milan
Humanitas Research Hospital
Toronto General Hospital
Ikerbasque, Basque Foundation for Science
Centre Hospitalier Universitaire de Liege
Capital University
Siriraj Hospital
Imperial College Healthcare NHS Trust
The Christie NHS Foundation Trust
Clínica Universidad de Navarra
Azienda Ospedale Università Padova
Pomeranian Medical University in Szczecin
UCL Cancer Institute
Hôpital Beaujon
Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas
Instituto Nacional de la Nutrición Salvador Zubiran
Asst Grande Ospedale Metropolitano Niguarda
Universidad Nacional Mayor de San Marcos
Università degli Studi di Firenze, Facoltà di Medicina e Chirurgia
Humanitas University
Hospital Clínico Universitario Virgen de la Arrixaca
Azienda Ospedaliero - Universitaria di Modena
International University of Health and Welfare
Lietuvos Sveikatos Mokslų Universitetas
Facoltà di Farmacia e Medicina
Facoltà di Medicina e Odontoiatria
Erasmus MC Cancer Institute
MRC Human Genetics Unit
Hospital Universitario Fundación Jiménez Díaz
University Hospital Alexandrovska
The Cima Universidad de Navarra
Biogipuzkoa Health Research Institute
Hospital Arnau de Vilanova
Vall d‘Hebron Institut de Oncologia
MRC Centre for Inflammation Research
The Hormel Institute
Sigmund Freud Privatuniversitat Wien
Beatson West of Scotland Cancer Centre
Biotech Research & Innovation Centre
Centre Eugène Marquis Rennes
Erasmus MC Transplant Institute
CRUK Scotland Institute
Klinikum Klagenfurt am Woerthersee
Cholangiocarcinoma Foundation
Biobizkaia Health Research Institute
The Cholangiocarcinoma Charity
RKH Klinikum
EASL International Liver Foundation
12Mayo Clinic Comprehensive Cancer Center
Corresponding Author(s)
Other Contributor(s)
Abstract
Cholangiocarcinoma (CCA) is a cancer that originates within the bile ducts. Traditionally considered to be a rare neoplasm, increased awareness of CCA alongside advancements in diagnosis and the rising prevalence of certain risk factors have contributed to a global increase in incidence and mortality. CCAs are highly heterogeneous from the clinical, histomorphological and molecular perspectives but commonly share a poor prognosis. These tumours usually develop and progress silently; by the time they are detected, it is often too late for curative surgical intervention. In such cases, current therapeutic approaches offer modest survival improvements and are generally considered palliative. Although well-known risk factors predispose individuals to developing CCA, the majority of cases are considered sporadic, occurring without any identifiable underlying condition. Over the past decade, substantial collaborative efforts have been made to improve our understanding of the aetiopathogenesis of these tumours, aiming to identify novel biomarkers and therapeutic targets to develop more effective treatments. The ultimate goal is to improve patient outcomes and overall well-being. However, there are significant gaps in our understanding of the molecular mechanisms that drive cholangiocarcinogenesis. In this international Consensus Statement, which is endorsed by the European Network for the Study of Cholangiocarcinoma, we provide a critical overview of the latest advancements in the field of CCA. We highlight the key aspects of CCA aetiopathogenesis and clinical management and provide insights into promising new treatments. Finally, we provide a set of consensus recommendations and future research priorities for CCA based on a Delphi panel questionnaire involving international experts.