Abstract
BACKGROUND: Intrahepatic cholangiocarcinoma (ICC) is a relatively uncommon but lethal neoplasm of the biliary tract. Evolving immunotherapy has important implications for the treatment of ICC. Novel immune checkpoint inhibitors (ICIs) continue to be identified and have demonstrated clinical efficacy in the treatment of ICC, though there are some issues. OBJECTIVE: This article profoundly discusses the core issues of immunotherapy for ICC, provides a comprehensive and systematic overview, and propose corresponding countermeasures to improve patient outcomes . METHODS: We analyze the tumor microenvironment to validate the important role of immune checkpoints in tumor immune escape. By incorporating multiple clinical and preclinical trials to summarize the latest advances in ICIs for ICC treatment, we investigate the current challenges and limitations of ICC immunotherapy and explore new directions for its development. RESULTS: Monotherapy approaches fail to achieve satisfactory outcomes in ICC. Combination therapies, such as the pairing of ICIs with chemotherapy, exhibit synergistic effects, overcome drug resistance and enhance therapeutic efficacy. Furthermore, targeted therapies, such as tyrosine kinase inhibitors and IDH inhibitors, have exhibited antitumor activity in the context of ICC. CONCLUSION: In summary, ICIs are assuming an increasingly prominent role in the management of ICC. Efforts should be made to improve treatment methods and apply combination therapy strategies to address drug resistance. The combination of multiple treatment methods and ongoing research are crucial for addressing the treatment of ICC.