CD274 and cholangiocarcinoma: Studies on the application of pembrolizumab for incurable cholangiocarcinoma in Phase I b and II trials have found that regardless of PD-L1 expression, it can effectively control 6%-13% of advanced bile duct cancers, with manageable toxicity (6).A real-world study based on Phase III clinical trial TOPAZ-1, incorporating durvalumab into the first-line chemotherapy regimen for cholangiocarcinoma, demonstrated a 20% reduction in the risk of death (HR=0.80, 95% CI: 0.66-0.97, P=0.021), confirming the efficacy and safety of durvalumab for cholangiocarcinoma patients (7).