In consistent with our previous research in osteosarcoma (9), avasimibe has a direct killing effect on bile duct cancer cells revealed by gene cluster analysis and altered genes related to cell proliferation, including CDK1, CDK6, cyclin B1, FoxM1, and, especially, Ki67 and PCNA, two essential biomarkers representing the ability of cell proliferation. This evidence concerns the gene PCNA and bile duct cancer.