Shivan Sivakumar, Professor of Translational Oncology at the University of Birmingham and Clinical Lead of Oncology at University Hospitals Birmingham NHS Foundation Trust, shared on LinkedIn:
“ESMO 2026: Are we finally seeing meaningful progress in cholangiocarcinoma?
Three important studies caught my attention, highlighting both the progress being made and the challenges of changing clinical practice.
HARMONi-GI1: Ivonescimab plus GemCis improved overall survival compared with durvalumab plus GemCis, with median overall survival of 14.9 vs 12.1 months (HR 0.75).
The result is promising, but the trial was conducted entirely in China, raising important questions about how broadly the findings can be applied to Western populations. A global phase III study is planned.
ACTICCA-1: Adjuvant GemCis showed a numerical improvement in disease-free survival compared with capecitabine, 25.7 vs 17.9 months, although the primary analysis did not reach statistical significance.
The study also highlights how difficult and time-consuming definitive adjuvant trials can be in rare cancers.
OPTIMUM: Maintenance olaparib with or without durvalumab did not meet its primary endpoint, although exploratory signals in HRD-selected patients suggest that improved biomarker selection may be important.
The science is moving faster than our ability to deliver definitive evidence. Promising treatments, long-running trials and questions around global applicability continue to shape the challenges ahead.”
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