Neoadjuvant Systemic Therapy for Intrahepatic Cholangiocarcinoma: Does It Help?

Surgery and adjuvant capecitabine remain the standard of care for resectable intrahepatic cholangiocarcinoma, but most patients still experience recurrence and die of their disease. In high-risk cases (e.g., large, multifocal tumors, lymph node involvement), specialists may give neoadjuvant therapy, but with little data to support it. An ongoing, randomized, phase 2/3 trial evaluating neoadjuvant gemcitabine, oxaliplatin, lenvatinib, and toripalimab (GOLP); surgery; and adjuvant capecitabine versus upfront surgery and adjuvant capecitabine addresses this gap. The primary endpoint of the study is event-free survival (EFS). The authors now report results from a prespecified interim analysis of 178 patients.