The Cholangiocarcinoma Foundation has published a white paper from the first Cure Cholangiocarcinoma Think Tank (C2T2 ) meeting, which gathered 29 expert scientists and clinicians from the world’s leading academic institutions. The multi-disciplinary group was led by Dr. Mitesh Borad and Dr. Nilo Azad, chairs of the International Cholangiocarcinoma Research Network (ICRN). Topics selected for the first C2T2 meeting reflected areas of urgency and opportunity for improving outcomes for people impacted by CCA – precision early diagnostics and prevention and precision therapeutics (specifically in the immune-oncology space).

Novel platforms in precision medicine and immuno-oncology are catalyzing change at an unprecedented pace in oncology. As a scientific community, we must harness these tools to their fullest extent…”

Dr. Mitesh J. Borad

The C2T2 meeting is geared towards making tangible progress in cholangiocarcinoma for patients now, harnessing the expertise of leaders in cancer research across disciplines…

Dr. Nilo Azad

“The C2T2 meeting brought together key experts across multiple cancer-states and disciplines. This group worked together to harness the power of their collective experience and insights into specific, patient-focused projects based on new and innovative methodologies and platforms…”

Stacie Lindsey, CCF CEO

Keynote Speaker


Aristides Patrinos, PhD

Distinguished C2T2 Participants


Mitesh Borad, MD – Co-Chair
Nilofer (Nilo) Azad, MD – Co-Chair
Jesús Bañales, PhD
Nabeel Bardeesy, PhD
Tomasz (Tom) Beer, MD
Chiara Braconi, MD
Elana Fertig, PhD
Sepideh Gholami, MD
Laura Goff, MD
Gregory Gores, MD
Lipika Goyal, MD

Manal Hassan, MD, PhD
Renuka Iyer, MD
Milind Javle, MD
Robin Kate (Katie) Kelley, MD
William “Billy” Kim, MD
Eugene Koay, MD, PhD
Stacie Lindsey, CCF CEO
Amit Mahipal, MBBS
Shishir Maithel, MD
Lynn Matrisian, PhD, MBA
Funda Meric-Bernstam, MD

Muhammed Murtaza, MBBS, PhD
Ruth-Anne Pai, PhD
Greg Sepich-Poore, PhD, MD candidate
Lewis Roberts, PhD
Flavio Rocha, MD, FACS, FSSO
Sameek Roychowdhury, MD, PhD
William “Bill” Sellers, MD
Rachna Shroff, MD
Ben Stanger, MD, PhD

Key Takeaways in the C2T2 White Paper


The C2T2 white paper summarizes the in-depth discussions on identified topics and the project proposals that resulted from the meeting.

  • The low incidence of CCA makes it challenging to power early detection studies, and most early detection tests are refined through case-controlled studies. These factors resulted in the agreement to identify a high-risk group of patients with Primary Sclerosing Cholangitis (PSC) and patients with a genetic predisposition for CCA by seeking to include CCA as part of a multi-cancer test.
  • Investigators will include CCA in a pre-specified multi-cancer test to predict CCA. Identifying a genetic predisposition or other risk groups, including real-life controls, and conducting prospective studies to define the performance of the test will be important as preliminary data is needed to show a meaningful result in rare cancers.
  • Using a multi-step approach, investigators will seek a more in-depth understanding of tumor biology at the genomic level. Evaluating tissue and looking at relevant, proximal body fluids such as bile, blood, and stool.
  • Many lessons were learned from the collaboration, including that for the most difficult challenges, no one agency has enough resources to go it alone. Science is increasingly interdisciplinary and driven by new technologies, requiring effective management of institutional considerations and emphasizing the importance of early coordination.

To read additional takeaways from the C2T2 white paper, click the button.