Next-generation sequencing identifies actionable targets in biliary tract cancer, changing treatment for fit patients.

• Roughly 50% of biliary tract cancer patients have actionable genomic alterations, especially in intrahepatic cholangiocarcinoma.
• Targeted therapies are showing clinical benefits and manageable safety profiles over standard treatments.

Surgeons should consider incorporating molecular profiling into patient assessments to optimize postoperative therapy options.

• Future strategies aim to address treatment resistance and better integrate targeted drugs into treatment pathways.