{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T16:22:58Z","timestamp":1783527778349,"version":"3.55.0"},"reference-count":31,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T00:00:00Z","timestamp":1783468800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Comprehensive genomic profiling (CGP) is increasingly incorporated into the management of biliary tract tumors (BTTs); however, single-center real-world data integrating clinical utility and site-specific genomic landscape remain limited. Methods: This retrospective single-center observational study included 91 patients with BTTs who underwent CGP. The primary endpoints were the rates of potentially actionable genomic alterations, expert panel-based therapeutic options, and implementation of genomically matched therapy. Secondary endpoints included the distribution of recurrent and clinically relevant genomic alterations according to the primary tumor site. Results: The cohort included 46 patients with intrahepatic cholangiocarcinoma (iCCA), 19 with extrahepatic cholangiocarcinoma (eCCA), 24 with gallbladder cancer (GBC), and 2 with ampullary tumors. CGP was successfully performed in all 91 patients. Reportable genomic alterations were detected in 88 patients (96.7%), whereas no reportable alteration was detected in three patients (3.3%). The most frequently altered genes were TP53 (51\/91, 56.0%), KRAS (21\/91, 23.1%), CDKN2A (18\/91, 19.8%), SMAD4 (14\/91, 15.4%), and ARID1A\/PBRM1 (12\/91, 13.2%). Potentially actionable genomic alterations were identified in 21 patients (23.1%). Expert panel-based therapeutic options were identified in 15 patients (16.5%), and genomically matched therapy was introduced in 7 patients (7.7%). Matched therapy was introduced the most frequently in iCCA (6\/46, 13%), followed by GBC (1\/24, 4.2%), whereas no patient with eCCA or ampullary tumor received matched therapy. Conclusions: CGP revealed a heterogeneous genomic landscape across BTT subtypes and provided clinically actionable information in a limited but meaningful subset of patients. The practical utility of CGP was the greatest in selected molecular subsets, particularly iCCA.<\/jats:p>","DOI":"10.3390\/cancers18142189","type":"journal-article","created":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T15:40:09Z","timestamp":1783525209000},"page":"2189","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Utility and Genomic Landscape of Comprehensive Genomic Profiling in Biliary Tract Tumors: A Single-Center Real-World Study"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7407-1763","authenticated-orcid":false,"given":"Kazunori","family":"Nakaoka","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Fujita Health University School of Medicine, Toyoake 470-1192, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery, Fujita Health University School of Medicine Bantane Hospital, Nagoya 454-8509, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seiji","family":"Yamada","sequence":"additional","affiliation":[{"name":"Division of Analytical Pathology, Oncology Invitation Center, Fujita Health University School of Medicine, Toyoake 470-1192, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fumino","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Cancer Genetics and Genomics, Fujita Health University Hospital, Toyoake 470-1192, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-2513-4250","authenticated-orcid":false,"given":"Yusaku","family":"Urakawa","sequence":"additional","affiliation":[{"name":"Department of Cancer Genetics and Genomics, Fujita Health University Hospital, Toyoake 470-1192, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gakushi","family":"Koumura","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Fujita Health University School of Medicine, Toyoake 470-1192, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Fujita Health University School of Medicine, Toyoake 470-1192, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuji","family":"Nakano","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Fujita Health University School of Medicine, Toyoake 470-1192, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1138-5631","authenticated-orcid":false,"given":"Sayaka","family":"Ueno","sequence":"additional","affiliation":[{"name":"Department of Cancer Genetics and Genomics, Fujita Health University Hospital, Toyoake 470-1192, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2229-990X","authenticated-orcid":false,"given":"Teiji","family":"Kuzuya","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Fujita Health University School of Medicine, Toyoake 470-1192, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7837-565X","authenticated-orcid":false,"given":"Hiroshi","family":"Matsuoka","sequence":"additional","affiliation":[{"name":"Department of Surgery, Fujita Health University School of Medicine, Toyoake 470-1192, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2106-5770","authenticated-orcid":false,"given":"Tamotsu","family":"Sudo","sequence":"additional","affiliation":[{"name":"Department of Cancer Genetics and Genomics, Fujita Health University Hospital, Toyoake 470-1192, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9639-7425","authenticated-orcid":false,"given":"Yoshiki","family":"Hirooka","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Fujita Health University School of Medicine, Toyoake 470-1192, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eizaburo","family":"Ohno","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Fujita Health University School of Medicine, Toyoake 470-1192, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1038\/ng.3375","article-title":"Genomic spectra of biliary tract cancer","volume":"47","author":"Nakamura","year":"2015","journal-title":"Nat. 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