Intrahepatic cholangiocarcinoma: lines of therapy

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7 standard-of-care settings across 4 lines and 3 biomarker subgroups. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.

Line	All comers	FGFR	IDH
Screening, prevention and diagnosis	1	·	·
Early / localised	1	·	·
Advanced, first line	2	·	·
Second line	1	1	1

Screening, prevention and diagnosis

Subgroup	Setting	Approach	Products and trials	Guideline	Evidence
All comers	Diagnosis	Contrast MRI and CT, biopsy, and comprehensive genomic profiling including RNA-based fusion detection for every patient.	MRICT (computed tomography)Comprehensive genomic profilingNext-generation sequencing (NGS)FGFR2 fusions and rearrangements		81

Early / localised

Subgroup	Setting	Approach	Products and trials	Guideline	Evidence
All comers	Resectable	Hepatectomy with lymph node dissection followed by six months of adjuvant capecitabine (BILCAP).	Hepatectomy (liver resection)Lymphadenectomy (lymph node dissection)BILCAPCapecitabine		82

Advanced, first line

Subgroup	Setting	Approach	Products and trials	Guideline	Evidence
All comers	Unresectable, liver-confined	Radioembolisation, stereotactic radiotherapy or hepatic artery infusion in specialised centres, usually with systemic therapy; liver transplantation in trials.	Radioembolisation (TARE / SIRT, yttrium-90)SBRT / SABR (stereotactic radiotherapy)Liver transplantation for cancer (Milan criteria and beyond)		40
All comers	Advanced, first line	Gemcitabine and cisplatin with durvalumab (TOPAZ-1) or pembrolizumab (KEYNOTE-966).	TOPAZ-1KEYNOTE-966ABC-02Gemcitabine + cisplatinDurvalumabPembrolizumabGemcitabine-cisplatin + PD-(L)1 blockade in biliary cancer		98

Second line

Subgroup	Setting	Approach	Products and trials	Evidence
All comers	Second line without a target	FOLFOX (ABC-06); trials.	FOLFOX (5-FU, leucovorin, oxaliplatin)Cytotoxic chemotherapy	94
FGFR	Advanced, FGFR2 fusion after chemotherapy	Pemigatinib (FIGHT-202) or futibatinib (FOENIX-CCA2); management of hyperphosphataemia and eye toxicity.	PemigatinibFutibatinibFIGHT-202FOENIX-CCA2FGFR2FGFR2 fusions and rearrangements	67
IDH	Advanced, IDH1 mutation after chemotherapy	Ivosidenib (ClarIDHy).	IvosidenibClarIDHyIDH1 / IDH2	89

Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.