Would you administer adjuvant chemotherapy for extrahepatic cholangiocarcinoma that has received neoadjuvant therapy and achieved near CR?  

Thank you for the question. This is a tough scenario as we really have no prospective, randomized studies of neoadjuvant therapy in the cholangiocarcinoma space and would depend somewhat on what the patient received neoadjuvant. Adjuvant capecitabine (sometimes SWOG regimen) still remains the standa...

If the regimen was well-tolerated and there is reason to believe that additional treatment could have been administered (preop tumor evaluation was not stalled out, suggesting ongoing response), I would favor additional therapy. You may also have a role for ctDNA monitoring but I know many are not i...