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Cholangiocarcinoma — SCE Medical Oncology MCQ

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HardGI CancersCholangiocarcinomaSCE Medical Oncology

After progression on gemcitabine-cisplatin-based treatment, a patient with advanced cholangiocarcinoma has an IDH1 R132C mutation but no FGFR2 fusion. Which targeted treatment is recommended by NICE?

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Correct answer: C — Ivosidenib for previously treated IDH1 R132-mutated disease

TA948 recommends ivosidenib for locally advanced or metastatic cholangiocarcinoma with an IDH1 R132 mutation after at least one systemic treatment. Pemigatinib requires FGFR2 fusion or rearrangement. IDH1 mutation does not by itself establish HRD, BRAF V600E or MSI-high status, so the other biomarker-directed options are unsupported.

Reference: NICE TA948 ivosidenib for previously treated IDH1 R132-mutated cholangiocarcinoma (Published January 2024): https://www.nice.org.uk/guidance/ta948/chapter/1-Recommendations