Nintedanib is an inhibitor of multiple tyrosine kinases, such as FGFR, VEGFR and PDGFR, and it has shown therapeutic effects against stromal fibrosis in patients with idiopathic pulmonary fibrosis.16–18 It was previously reported that nintedanib clearly suppressed chemical-induced liver fibrosis through the suppression of activated hepatic stellate cells with α-SMA, which is a marker of activated-stellate cells.19 In this study, antifibrotic drug nintedanib suppressed activated CAFs with α-SMA, which could enhance the aggressiveness of ICC cells. Here, ACTA1 is linked to intrahepatic cholangiocarcinoma.