The KEYNOTE-028 trial reported that 17% of patients with PD-L1-positive advanced BTCs obtained partial response (PR) from pembrolizumab monotherapy.12 In another basket trial, pembrolizumab resulted in 100% disease control in four patients with tumor DNA mismatch repair (MMR)-deficient cholangiocarcinoma.13 However, MMR deficiency occurred in only 5%–10% of patients with BTCs.14 Therefore, novel strategies that could improve the efficacy of ICIs are urgently needed. Here, CD274 is linked to neoplasm.