Cholangiocarcinoma Foundation's 20th Annual Conference (May 2026)

Hope, Progress, and the Future of Cholangiocarcinoma Research

The 2026 Cholangiocarcinoma Foundation Conference brought together patients, caregivers, clinicians, researchers, advocates, and industry partners in Salt Lake City to share the latest progress in cholangiocarcinoma research and care.¹

A key message from the conference was clear: research in cholangiocarcinoma is advancing rapidly, but access to appropriate testing, clinical trials, and expert care remains essential.

Molecular Testing Is More Important Than Ever

Many of the most promising treatment options depend on understanding the biology of a person’s tumour. This is why molecular testing, also called biomarker or genomic testing, plays such an important role. These tests look for specific changes in the cancer, such as FGFR2, IDH1, HER2, BRAF, NTRK, RET, KRAS, and others, that may help guide treatment decisions or identify clinical trial options.²

New Targets and Treatment Approaches

Several sessions focused on emerging treatment targets. One example was CLDN18.2, a protein found on some cancer cells. A CLDN18.2-targeted treatment, zolbetuximab, is approved in the United States for certain gastric and gastroesophageal cancers, but research in cholangiocarcinoma is still in early stages.³ Testing for CLDN18.2 is typically done using IHC, a tissue-based staining method, rather than standard DNA sequencing.

There was also growing excitement around KRAS and RAS-targeted therapies. KRAS was once considered very difficult to treat, but new approaches are changing that. Daraxonrasib (RMC-6236) is an investigational RAS inhibitor. As of May 2026, it has been made available through FDA expanded access for patients with previously treated metastatic pancreatic cancer. While it is not approved for cholangiocarcinoma, it highlights an important and evolving area of research.⁴

Another emerging area is NRG1 fusion-positive cholangiocarcinoma. In April 2026, a supplemental FDA application was submitted for zenocutuzumab for patients with this alteration, and it has been included in NCCN guidelines for this subgroup.⁵

Immunotherapy, T Cells, and New Scientific Insights

A real highlight of the conference was Dr. Tak Mak’s presentation. His work has played a foundational role in cancer immunology, including how T cells recognize and respond to cancer and how immune “checkpoints” can be targeted with therapy. His talk connected decades of scientific discovery to future treatment strategies, including the role of IDH1 mutations, metabolism, and the immune system.

Other sessions explored TIL therapy, CAR-T cells, antibody-drug conjugates, and other immune-based approaches. Many of these treatments are still in early development, but they reflect a shift toward more personalized and targeted therapies.

Surgery and Local Treatment Options

Surgery continues to play a critical role for patients whose cancer can be safely removed. Presentations highlighted factors that influence surgical decisions, including tumour size, lymph node involvement, liver function, and the amount of healthy liver that would remain after surgery.

Local treatments such as Y90, ablation, TACE, HAIP, and histotripsy were also discussed. These approaches may be used for patients whose tumours cannot be removed right away, either to control disease or as a bridge to other treatments.

A Realistic View of Artificial Intelligence

There was also an important discussion on artificial intelligence in cancer care. While AI can help process large amounts of information, it is not a substitute for clinical expertise. Examples showed that AI can provide confident responses while missing key clinical details or offering recommendations that do not fully reflect a patient’s situation.

The takeaway is that AI may become a helpful support tool, but high-quality care still depends on experienced clinicians, multidisciplinary teams, and thoughtful, patient-centered decision-making.

Canadian Presence and Community Hope

Canada was well represented at the conference, with patients, caregivers, clinicians, and researchers attending from across the country. Attendees also contributed messages of hope for C3 care kits, helping support and encourage newly diagnosed patients. We had a Canadian dinner and all ate Venezuelan cuisine and went for some dairy free ice cream afterwards too :)

Key Takeaways

• Research in cholangiocarcinoma is advancing quickly.

• Molecular testing is essential for understanding treatment and clinical trial options.

• Emerging treatment areas include CLDN18.2, KRAS/RAS, NRG1 fusions, FGFR2 resistance strategies, improved IDH1 therapies, immunotherapy, antibody-drug conjugates, TIL therapy, and CAR-T approaches.

• Many promising treatments are still in early stages or available only through clinical trials.

• There is strong momentum in research, but improving access to testing and treatments remains a key priority, especially in Canada.

  
  
  
  

References

1. Cholangiocarcinoma Foundation, 13th Annual Cholangiocarcinoma Foundation Conference 

2. ESMO Clinical Practice Guideline interim update on biliary tract cancer 

3. FDA, zolbetuximab approval for CLDN18.2-positive gastric or gastroesophageal junction cancer 

4. FDA, expanded access for investigational daraxonrasib/RMC-6236 in pancreatic cancer 

5. Partner Therapeutics, zenocutuzumab sBLA for NRG1 fusion-positive cholangiocarcinoma