VIDEO: Future research focus on improving response to immunotherapy in cholangiocarcinoma

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Yeah, I think in terms of research opportunities, again, cholangiocarcinoma is a traditionally cold tumor. So meaning that the immune microenvironment, it needs to be heated up. So we need to sensitize these tumors to immunotherapy. So I think the future here, like I mentioned, the role of immunotherapy is at this point, yes, it's part of frontline, but I think there's so much more we could do. So improving upon that. What are some of the strategy we could do to improve response to immunotherapy? And so that's one area. And then moving up to the adjuvant setting, if you know in this disease the only FDA approved standard of care therapy in the adjuvant setting, is oral capecitabine based on the BILCAP study. We know it's an option, but we could do better in that space because obviously there's still a high risk of recurrence. In the adjuvant space, we need to do better. There are trials now exploring immunotherapy in the adjuvant space. So that's one area. Is there a role for even targeted therapy in the adjuvant space? That's also an important question to answer. Obviously these are gonna be difficult studies to do. Looking at adjuvant targeted therapy in cholangiocarcinoma, it's gonna be very tough because it's the small numbers and it's a rare disease. But that's an important question. And even beyond that, in the neoadjuvant space, is there an opportunity to even intervene earlier in the disease course? For example, immunotherapy in my opinion, will probably be more impactful when the tumor is still in situ. You give immunotherapy, generate an immune response as opposed to in the adjuvant setting when you've already taken the tumor out. So those are some of the strategies that I think we are now thinking about to try to intervene earlier, much earlier in the disease course. Would it be with immunotherapy or targeted therapy? So I think that's kind of where a lot of the ongoing clinical trial efforts are directed.