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ESMO 2025 | The importance of genetic testing & targeted therapy in cholangiocarcinoma

Ghassan Abou-Alfa, MD, Memorial Sloan Kettering Cancer Center, New York, NY, discusses the importance of genetic testing in cholangiocarcinoma, specifically the mutated IDH1, which occurs in approximately 15% of patients and offers a potential therapeutic opportunity with ivosidenib. Prof. Abou-Alfa emphasizes the need for prompt next-generation sequencing and a multidisciplinary approach, involving oncologists, surgical oncologists, gastroenterologists, and primary care physicians, to ensure timely evaluation and treatment. This interview took place at the European Society for Medical Oncology (ESMO) 2025 Congress in Berlin, Germany.

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Transcript

Well, hello everybody and so nice to connect again here from ESMO 2025 in Berlin. It was a great delight and it’s a great meeting and we had the opportunity to talk about many things. I can at least summarize a few of the components that we really tackled on a little bit more in detail, specifically in regard to cholangiocarcinoma, the mutated IDH1. As you know, we’ve been really going through that process for a long period of time, and we’re delighted to see that the mutation IDH1 probably occurred in about 15% of patients with cholangiocarcinoma, but if anything, it can really imply a great opportunity for therapy with ivosidenib...

Well, hello everybody and so nice to connect again here from ESMO 2025 in Berlin. It was a great delight and it’s a great meeting and we had the opportunity to talk about many things. I can at least summarize a few of the components that we really tackled on a little bit more in detail, specifically in regard to cholangiocarcinoma, the mutated IDH1. As you know, we’ve been really going through that process for a long period of time, and we’re delighted to see that the mutation IDH1 probably occurred in about 15% of patients with cholangiocarcinoma, but if anything, it can really imply a great opportunity for therapy with ivosidenib. Very important, and this is a question that was asked by our colleagues here at ESMO. When do you do it? I would say as soon as you can. It’s very important. The minute the patient comes to you, you have to start the genetic testing. The next-generation sequencing is very important. We know all of us take a little bit longer time, but it’s important to really do it ASAP. And an important question that they were also asked about is like, you know, who will be involved in this? I think all of us. What I mean by all of us, all the disciplines. Of course, the oncologist, because we’re going to probably take care of the patient, but at the same time, we should really value and appreciate all what our colleague in surgical oncology will do for that purpose, because it might be the first touch point for the patient, our colleague in gastroenterology, even our primary care physicians. And as such, all of us will be involved to make sure that we get the evaluation of the next-generation sequencing ASAP, so we can really ensure that patients will benefit from therapies like, as an example, as we just mentioned, ivosidenib was almost doubling in survival based on the RPSFT that we already published in the Lancet Oncology.

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