Advancing immunotherapy for intrahepatic cholangiocarcinoma: exploring the tumor immune microenvironment and innovative treatments

Intrahepatic cholangiocarcinoma (ICC), a highly malignant tumor characterized by poor prognosis, has shown limited response to conventional treatments. Recently, advances in immunotherapy have offered new hope for treating such tumors. This article reviews the tumor immune microenvironment (TIME) of ICC, its pivotal role in immunotherapy, and methods to enhance ICC treatment by converting ‘cold tumors’ to ‘hot tumors’ through immune activation. Additionally, the article examines the characteristics of immune checkpoint inhibitors and their essential role in immunotherapy. Recent research and clinical trial outcomes for various immunotherapeutic approaches - namely immune checkpoint inhibitors (ICIs), cancer vaccines, and adoptive cell therapy (ACT) - are detailed, highlighting challenges in patient variability, side effect management, cost, and treatment accessibility. Furthermore, the article explores future research directions such as identifying new immunotherapy targets, applying precision medicine, and developing integrated therapeutic strategies to enhance immunotherapy efficacy and improve survival rates for ICC patients.