AL in combination with an anti-fibrotic agent, followed by gemcitabine/cisplatin, is suggested for mesenchymal iCCA (I4: 28%) [2] as it supports the reduction in tumor cell fibrosis through inhibition of MMP-2, and MMP-9 [14], thus augmenting the cytotoxic effects and facilitating the recruitment of CD4+, CD8+, and NK cells. Here, MMP9 is linked to neoplasm.