The faculty synthesize the evidence into clinical positioning and outline the questions that remain open. They summarize that durvalumab plus gemcitabine and cisplatin is FDA approved and guideline-endorsed as first-line therapy for unresectable or metastatic biliary tract cancer, supported by long-term follow-up without new safety signals and by independent real-world data confirming that efficacy translates to routine practice. The panel then identifies unresolved issues, beginning with the optimal duration of the immunotherapy and chemotherapy components. The absence of a validated predictive biomarker is revisited. Best sequencing strategy after progression is also unsettled, although the panel emphasizes targeting mutations in real-world practice. Looking ahead, the faculty discuss combination approaches in early-phase investigation.
