Therefore, the European Society for Medical Oncology (ESMO) recommends multi-gene sequencing (NGS) to detect ESCAT (ESMO Scale for Clinical Actionability of molecular Targets) level I genomic alterations in advanced cholangiocarcinoma as early as the first line of therapy [15,16] (including IDH1 mutations, FGFR2 fusions and MSI-H status). This evidence concerns the gene IDH1 and cholangiocarcinoma.