SEOM-GEMCAD-TTD clinical guidelines for biliary tract cancer (2025).

Biliary tract cancers (BTC) are aggressive and fatal. Early recognition of symptoms and proper diagnostic work up allow for precise histopathological and molecular classification as well as accurate evaluation of the extent of disease. Surgery is the only potentially curative therapy in localized stages; however, disease recurrence is common and adjuvant chemotherapy appears to improve survival. Upfront systemic chemotherapy with immunotherapy is the treatment of choice in unresectable locally-advanced and metastatic disease. Inroads made in understanding its molecular biology has enabled new therapeutic targets to be identified with current indications and encouraging results that could further improve BTC patients' survival and quality of life.