Neoadjuvant GOLP Doubles Event-Free Survival in Cholangiocarcinoma

Intrahepatic cholangiocarcinoma is an aggressive biliary tract malignancy characterized by poor long-term outcomes and high rates of disease recurrence, even following curative-intent surgical resection [1, 2]. While surgery remains the only definitive curative modality, a significant proportion of patients harbor micrometastatic disease at the time of operation, underscoring the urgent need for effective perioperative systemic therapies [3]. Adjuvant regimens, such as capecitabine, have become standard practice to help reduce postoperative recurrence, yet the role of neoadjuvant treatment remains largely investigational [2]. Recent efforts have explored various combinations of chemotherapy, targeted agents, and immunotherapy to downsize tumors and control early micrometastases before patients reach the operating room [4, 1]. A recent phase 2-3 trial evaluates how a specific multi-agent neoadjuvant approach, the GOLP regimen (intravenous gemcitabine and oxaliplatin, oral lenvatinib, and the programmed cell death protein-1 inhibitor toripalimab), affects survival outcomes for patients with high-risk, resectable disease [5].