{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T14:25:40Z","timestamp":1788272740340,"version":"build-2803163510"},"reference-count":136,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2024,12,31]],"date-time":"2024-12-31T00:00:00Z","timestamp":1735603200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Biliary tract cancers (BTC) are a highly heterogeneous group of cancers at the genomic, epigenetic and molecular levels. The vast majority of patients initially present at an advanced (unresectable) disease stage due to a lack of symptoms and an aggressive tumour biology. Chemotherapy has been the mainstay of treatment in patients with advanced BTC but the survival outcomes and prognosis remain poor. The addition of immune checkpoint inhibitors (ICI) to chemotherapy have shown only a marginal benefit over chemotherapy alone due to the complex tumour immune microenvironment of these cancers. This review appraises our current understanding of the immune landscape of advanced BTC, including emerging transcriptome-based classifications, highlighting the mechanisms of immune evasion and resistance to ICI and their therapeutic implications. It describes the shifting treatment paradigm from traditional chemotherapy to immunotherapy combinations as well as the potential biomarkers for predicting response to ICI.<\/jats:p>","DOI":"10.3390\/curroncol32010024","type":"journal-article","created":{"date-parts":[[2024,12,31]],"date-time":"2024-12-31T10:15:28Z","timestamp":1735640128000},"page":"24","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["The Immune Landscape and Its Potential for Immunotherapy in Advanced Biliary Tract Cancer"],"prefix":"10.3390","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-4436-5705","authenticated-orcid":false,"given":"Andry","family":"Santoso","sequence":"first","affiliation":[{"name":"Gastrointestinal Unit, The Royal Marsden Hospital, London SW3 6JJ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9825-8728","authenticated-orcid":false,"given":"Iris","family":"Levink","sequence":"additional","affiliation":[{"name":"Gastrointestinal Unit, The Royal Marsden Hospital, London SW3 6JJ, UK"},{"name":"Department of Gastroenterology and Hepatology, Erasmus MC University Medical Centre, 3015 GD Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6055-334X","authenticated-orcid":false,"given":"Rille","family":"Pihlak","sequence":"additional","affiliation":[{"name":"University Hospitals Sussex NHS Foundation Trust, Brighton BN1 9RW, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0286-8703","authenticated-orcid":false,"given":"Ian","family":"Chau","sequence":"additional","affiliation":[{"name":"Gastrointestinal Unit, The Royal Marsden Hospital, London SW3 6JJ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1097\/01.sla.0000251366.62632.d3","article-title":"Cholangiocarcinoma: Thirty-one-year experience with 564 patients at a single institution","volume":"245","author":"DeOliveira","year":"2007","journal-title":"Ann. 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