The main purposes of research in cholangiocarcinoma (CCA) are prevention, early diagnosis and the development of effective therapies tailored to each patient’s clinical course and general condition.1 This holistic vision is integral to the framework of P5 Medicine (personalised, predictive, preventive, participatory and population-based) and aligns with the modern principles of translational and precision medicine.2 Within this framework, the traditional notion of diagnosis as a ‘box that contains’ must be re-examined in light of the true pathobiological determinants of both the patient and the disease.3 4 Accompanying this evolutionary journey in biomedicine is the concept of biomarkers, which many regard as the key enabler of P5 Medicine.

CCA still suffers from a lack of precision in both clinical and research approaches.3 4 The anatomical classification of biliary tract cancer (BTC), including CCA, gallbladder cancer and ampullary cancer, and the…