The new era of cholangiocarcinoma treatment: application of nano-based drug delivery systems

Cholangiocarcinoma (CCA) is a rare primary cancer of the bile duct epithelium, accounting for about 3% of all gastrointestinal cancers worldwide. CCA incidence is notably higher in Southeast and East Asia, particularly in northeastern Thailand. The early diagnosis of CCA is limited, while the cancer tends to metastasize rapidly, contributing to high mortality rates. Current treatments for CCA, including conventional chemotherapies, often cause drug resistance and induce significant side effects due to the drug going off-target. This underlines the need for novel therapeutic strategies, including chemopreventive and adjuvant treatments. Targeted drug delivery systems using nano-based technologies offer a promising approach to enhance treatment specificity and effectiveness, thereby minimizing side effects. This review provides an overview of nanomedicine’s application in the treatment of CCA. Polymeric and lipid-based nanoparticles (NPs), as examples of passive targeting mechanisms such as the enhanced permeability and retention effect, are discussed. Additionally, functionalized NPs are described, focusing on their role in active targeting strategies in CCA therapy. This summary will support the development of more effective drugs for CCA.