APPLE 2026 | Prof. Stephen L. Chan: The Art and Science of Conversion Therapy in Cholangiocarcinoma
Cholangiocarcinoma is characterized by its high malignancy, with the majority of patients presenting with unresectable disease at initial diagnosis. In recent years, conversion therapy—which utilizes systemic treatment to downsize tumors—has emerged as a pivotal, offering select patients a pathway to curative-intent resection. However, striking the right balance between therapeutic efficacy and overtreatment remains a significant clinical challenge. At APPLE 2026, Prof. Stephen L. Chan, from the Chinese University of Hong Kong (CUHK) Faculty of Medicine, offered an in-depth analysis of these issues during an exclusive interview with our journal. Prof. Chen advocates for earlier genomic testing for alterations such as FGFR2 and IDH1, and proposes a multidimensional assessment framework combining radiology with circulating biomarkers like ctDNA and MRD to precisely identify the optimal surgical window. Furthermore, he recommends a stratified postoperative strategy guided by pathological response (MPR/pCR) to maximize recurrence-free survival.









