A high expression level of vascular endothelial growth factor (VEGF) was detected in 53.8% of ICC and was considered to be involved in hematogenic metastasis.20 The FGFR signaling pathway is also abnormally activated in ICC and is associated with poor prognosis.21 Finally, considering that lenvatinib and chemotherapy regimens can significantly upregulate PD-L1 expression,22 using these therapies with anti-PD-1 treatment may significantly enhance their effects. This evidence concerns the gene CD274 and intrahepatic cholangiocarcinoma.