Harnessing cellular immunotherapy for cholangiocarcinoma: an integrated roadmap for overcoming resistance

The rising global incidence and dismal prognosis of cholangiocarcinoma (CCA) underscore the profound limitations of standard therapies. While chimeric antigen receptor (CAR)-based cellular immunotherapies represent a paradigm shift in oncology, their success in CCA is fundamentally constrained by a desmoplastic, immunosuppressive tumour microenvironment (TME) and significant tumour antigen heterogeneity. This review advances the thesis that overcoming these barriers requires an integrated approa