Pembrolizumab plus chemotherapy as first-line treatment for advanced biliary tract cancer

Biliary tract cancers have increased in incidence in many parts of the world, particularly cases of intrahepatic disease.1,2 The incidence of cholangiocarcinoma varies geographically, with 1·6 cases per 100 000 people in the USA, for example, but substantially higher rates in parts of east Asia.2 Most patients present with advanced disease not amenable to surgery and require systemic therapy. For more than 10 years, gemcitabine and cisplatin was the internationally accepted first-line treatment for patients with locally advanced and metastatic biliary tract cancer, as per the ABC-02 study.