Chemotherapy combined targeted therapy has a potential benefit on the survival of advanced intrahepatic cholangiocarcinoma.

The treatment strategies and outcomes for advanced intrahepatic cholangiocarcinoma (ICC) are restricted. The treatment modalities and effectiveness of local interventional chemotherapy and systemic chemotherapy remain indeterminate. The objective of this study is to explore and assess the influence of different chemotherapy methods on the prognosis of patients with advanced ICC. A retrospective investigation was carried out at two research centers. The recruited patients were divided into the systemic chemotherapy cohort and the local chemotherapy cohort (Transarterial Chemoembolization, TACE). The primary endpoint of this study was overall survival (OS), while the secondary endpoints encompassed progression free survival (PFS), response rate (RR), and adverse events (AE). From January 2014 to January 2024, a total of 124 patients were included. Systemic/local chemotherapy combined with targeted therapy exhibited superior survival performance compared to chemotherapy alone. Additionally, patients with lesions confined to the liver and large tumors (> 6 cm) obtained better survival benefits from systemic chemotherapy. There was no significant disparity in grade 3 or more severe adverse events between the two groups. Whether it is systemic chemotherapy or TACE, combining them with targeted therapy can confer significant therapeutic advantages to patients with advanced ICC. ICC patients with a higher tumor burden may attain better therapeutic outcomes by selecting systemic chemotherapy.