Treatment decisions for CCA are also guided by the presence of gene alterations, such as in fibroblast growth factor receptor (FGFR) 2, isocitrate dehydrogenase (IDH) 1 and 2, KRAS, and BRAF [5–7]; in particular, FGFR2 fusion detected in patients with CCA generally appear to be mutually exclusive with KRAS and BRAF mutations [8], similar to gastric cancer [9]. Here, KRAS is linked to cholangiocarcinoma.