- The market size for biliary tract cancer was found to be USD 1.1 billion in the 7MM in 2024.
- The United States accounted for the largest biliary tract cancer treatment market size, approximately 60% of the total market size in the 7MM in 2024, compared to other major markets, including the EU4 countries (Germany, France, Italy, and Spain), the United Kingdom, and Japan.
- In 2024, chemotherapy regimens continued to dominate the BTC market by therapy, accounting for ~70% of the market.
- In 2024, the total number of BTC incident cases across the 7MM was approximately 65,000, and this burden is projected to increase over the forecast period.
- Leading biliary tract cancer companies, such as TransThera Sciences (HKG: 2617), AstraZeneca (LON: AZN), J-Pharma, OHARA Pharmaceutical (TYO: 5218), Compass Therapeutics (NASDAQ: CMPX), Merck (NYSE: MRK), Eisai (TYO: 4523), Seagen (NASDAQ: SGEN), Pfizer (NYSE: PFE), Bold Therapeutics (NASDAQ: BOLD), Senhwa Biosciences, Virogin Biotech, Replimune (NASDAQ: REPL), Bayer (ETR: BAYN), RedHill Biopharma (NASDAQ: RDHL), Relay Therapeutics (NASDAQ: RLAY), Elevar Therapeutics, Eli Lilly (NYSE: LLY), Cogent Biosciences (Cogent Biosciences), Tanabe Pharma America (TYO: 4508), and others, are developing new biliary tract cancer treatment drugs that can be available in the biliary tract cancer market in the coming years.
- The promising biliary tract cancer therapies in clinical trials include Tinengotinib, Rilvegostomig, Nanvuranlat (JPH203), Tovecimig (CTX-009), Lenvatinib mesylate (LENVIMA), Tucatinib (TUKYSA), BOLD-100, Silmitasertib (CX-4945), VG161, RP3-003, Sevabertinib (BAY 2927088), Opaganib (ABC294640), Lirafugratinib (RLY-4008), Olomorasib (LY3537982), CGT4859, MT-4561, and others.
- According to DelveInsight’s analysis, by 2034, among therapies, the highest revenue is expected to be generated by chemotherapy, followed by durvalumab (IMFINZI) and tovecimig in the 7MM.
- Rising BTC Incidence and Aging Populations: The global incidence of biliary tract cancers, including cholangiocarcinoma and gallbladder cancer, is increasing. The US accounted for approximately 19K biliary tract cancer cases in 2024, which are further expected to increase by 2034. This trend is attributed to factors such as aging populations, the rising prevalence of chronic liver diseases (like cirrhosis and hepatitis), and certain parasitic infections. The aging global population and environmental factors like obesity further contribute to the rise in diagnosed cases.
- Advancements in Imaging for Cholangiocarcinoma: Improving imaging techniques, such as magnetic resonance imaging (MRI), endoscopic ultrasound (EUS), and positron emission tomography (PET), can enhance the accuracy of diagnosis, staging, and monitoring of cholangiocarcinoma, facilitating more tailored treatment approaches.
- Potential of FGFR2 Inhibitors: FGFR2 inhibitors such as pemigatinib and futibatinib have been effective in patients with FGFR2 alterations; however, resistance due to secondary mutations remains a challenge.
- Launch of Emerging Biliary Tract Cancer Drugs: The dynamics of the BTC market are expected to change in the coming years due to the launch of emerging therapies such as Tinengotinib (TransThera Sciences), Rilvegostomig (AstraZeneca), Nanvuranlat (JPH203) (J-Pharma/OHARA Pharmaceutical), Tovecimig (CTX-009) (Compass Therapeutics), Lenvatinib mesylate (LENVIMA) (Merck/Eisai), Tucatinib (TUKYSA) (Seagen/Pfizer), BOLD-100 (Bold Therapeutics), Silmitasertib (CX-4945) (Senhwa Biosciences), VG161 (Virogin Biotech), RP3-003 (Replimune), Sevabertinib (BAY 2927088) (Bayer), Opaganib (ABC294640) (RedHill Biopharma), Lirafugratinib (RLY-4008) (Relay Therapeutics/Elevar Therapeutics), Olomorasib (LY3537982) (Eli Lilly), CGT4859 (Cogent Biosciences), MT-4561 (Tanabe Pharma America), and others.
- Therapeutic management of BTC is determined by disease stage and anatomical subtype.
- Early-stage BTC can be curable with surgical resection; however, most patients are ineligible due to late diagnosis.
- High rates of post-surgical recurrence highlight the limited durability of surgery alone and the need for adjuvant systemic therapy.
- In unresectable or metastatic BTC, first-line chemotherapy remains the standard of care but provides only modest and short-lived benefit.
- Rapid disease progression in advanced BTC leads to high attrition and limits access to subsequent lines of therapy.
- Molecular profiling has driven a major shift in the treatment landscape, particularly in iCCA, enabling the identification of actionable genomic alterations.
- Targeted therapies for molecularly selected subgroups have improved outcomes relative to historical standards.
- Significant treatment gaps persist among patients without actionable mutations, despite recent advances in targeted therapies.
- Over the next 3–5 years, bispecific antibodies and antibody-drug conjugates are expected to drive another major therapeutic shift, although testing and toxicity management challenges persist.
- Platinum-based combination chemotherapy has long served as the backbone of systemic therapy for advanced or unresectable BTC across the 7MM.
- Pembrolizumab in combination with platinum-based chemotherapy is approved for locally advanced unresectable or metastatic BTC, establishing immunotherapy in the first-line setting.
- Durvalumab combined with gemcitabine and platinum chemotherapy is also an established first-line immunochemotherapy regimen for advanced BTC in major regulatory regions.
- Recent approvals have expanded targeted options: FGFR inhibitors (pemigatinib, futibatinib) for FGFR2-fusion-positive cholangiocarcinoma and IDH1 inhibitor ivosidenib for previously treated IDH1-mutated disease.
- Additional established targeted agents include PD-1/TIGIT, HER2, TROP2, DLL4, VEGF-A, and HER2/mEGFR–directed therapies.
- Emerging therapies such as Tinengotinib (TransThera Sciences), Rilvegostomig (AstraZeneca), Nanvuranlat (JPH203) (J-Pharma/OHARA Pharmaceutical), Tovecimig (CTX-009) (Compass Therapeutics), Lenvatinib mesylate (LENVIMA) (Merck/Eisai), Tucatinib (TUKYSA) (Seagen/Pfizer), BOLD-100 (Bold Therapeutics), Silmitasertib (CX-4945) (Senhwa Biosciences), VG161 (Virogin Biotech), RP3-003 (Replimune), Sevabertinib (BAY 2927088) (Bayer), Opaganib (ABC294640) (RedHill Biopharma), Lirafugratinib (RLY-4008) (Relay Therapeutics/Elevar Therapeutics), Olomorasib (LY3537982) (Eli Lilly), CGT4859 (Cogent Biosciences), MT-4561 (Tanabe Pharma America), and others, continue to focus on pathway inhibition through novel inhibitors and antibodies, supporting more personalized treatment approaches beyond traditional chemotherapy.
- In December 2025, Compugen announced an agreement with AstraZeneca to monetize a portion of its future royalties from rilvegostomig. As part of this transaction, Compugen amended its exclusive license agreement with AstraZeneca, originally executed in March 2018, to strengthen its balance sheet and advance its differentiated immuno-oncology pipeline.
- In July 2025, Jazz Pharmaceuticals announced that the European Commission granted conditional marketing authorization for ZIIHERA as monotherapy for the treatment of adults with unresectable, locally advanced, or metastatic HER2-positive (IHC 3+) BTC who had received at least one prior line of systemic therapy.
- In April 2025, TransThera announced poster presentations at the 2025 AACR Annual Meeting to discuss clinical data on tinengotinib in patients with advanced solid tumors from a Phase Ib/II study.
- Total Incident Cases of BTC
- Tumor Site-specific Incident Cases of BTC
- Age-specific Incident Cases of BTC
- Stage-specific Incident Cases of BTC
- Mutation-specific Incident Cases of BTC
- Line-wise Treated Cases of BTC
|
Biliary Tract |
Details |
|
Study Period |
2020–2034 |
|
Coverage |
7MM [The United States, the EU4 (Germany, France, Italy, and Spain), the United Kingdom, and Japan]. |
|
Biliary Tract |
10.1 % |
|
Biliary Tract |
USD 1.1 Billion |
|
Key Biliary Tract |
TransThera Sciences (HKG: 2617), AstraZeneca (LON: AZN), J-Pharma, OHARA Pharmaceutical (TYO: |
|
Key Biliary Tract |
Tinengotinib, Rilvegostomig, Nanvuranlat (JPH203), Tovecimig (CTX-009), Lenvatinib mesylate |
- Therapeutic Assessment: Biliary Tract Cancer current marketed and emerging therapies
- Biliary Tract Cancer Market Dynamics: Key Market Forecast Assumptions of Emerging Biliary Tract Cancer Drugs and Market Outlook
- Competitive Intelligence Analysis: SWOT analysis and Market entry strategies
- Unmet Needs, KOL’s views, Analyst’s views, Biliary Tract Cancer Market Access and Reimbursement
|
1 |
Biliary Tract Cancer Market Key Insights |
|
2 |
Biliary Tract Cancer Market Report Introduction |
|
3 |
Executive Summary |
|
4 |
Key Events |
|
4.5 |
News Flow |
|
5 |
Epidemiology and Market Forecast Methodology |
|
6 |
BTC Market Overview at a Glance |
|
7 |
Disease Background and Overview |
|
7.1 |
Introduction |
|
7.2 |
Classification of BTC |
|
7.3 |
Staging |
|
7.4 |
Signs and Symptoms |
|
7.5 |
Causes and Risk Factors |
|
7.6 |
Pathophysiology |
|
7.7 |
Genetic Findings in BTC |
|
7.8 |
Biomarkers |
|
7.9 |
Diagnosis of BTC |
|
7.10 |
Differential Diagnosis |
|
7.11 |
Treatment |
|
7.12 |
Diagnostic and Treatment Guidelines for BTC |
|
8 |
Epidemiology and Patient Population |
|
8.1 |
Key Findings |
|
8.2 |
Assumptions and Rationale |
|
8.3 |
Total Incident Cases of BTC in the 7MM |
|
8.4 |
The United States |
|
8.4.1 |
Total Incident Cases of BTC in the United States |
|
8.4.2 |
Tumor Location-specific of BTC in the United States |
|
8.4.3 |
Age-specific Incident Cases of BTC in the United States |
|
8.4.4 |
Stage-specific Incident Cases of BTC in the United States |
|
8.4.5 |
Mutation-specific Incident Cases of BTC in the United States |
|
8.4.6 |
Systemic inflammation in BTC in the United States |
|
8.5 |
EU4 and the UK |
|
8.6 |
Japan |
|
9 |
Biliary Tract Cancer Patient Journey |
|
10 |
Marketed Biliary Tract Cancer Therapies |
|
10.1 |
Key Cross Competition |
|
10.2 |
Pemigatinib (PEMAZYRE): Incyte |
|
10.2.1 |
Product Description |
|
10.2.2 |
Regulatory Milestones |
|
10.2.3 |
Other Developmental Activities |
|
10.2.4 |
Summary of Pivotal Trials |
|
10.2.5 |
Analyst’s View |
|
10.3 |
Entrectinib (ROZLYTREK): Roche/Genentech |
|
10.4 |
Larotrectinib (VITRAKVI): Bayer/Loxo Oncology |
|
10.5 |
Ivosidenib (TIBSOVO): Agios Pharmaceuticals/Servier Pharmaceuticals |
|
10.6 |
Futibatinib (LYTGOBI): Taiho |
|
10.7 |
Pembrolizumab (KEYTRUDA): Merck |
|
10.8 |
Durvalumab (IMFINZI): AstraZeneca |
|
10.9 |
Dabrafenib (TAFINLAR) + Trametinib (MEKINIST): Novartis |
|
10.10 |
Selpercatinib (RETEVMO): Eli Lilly |
|
10.11 |
Zanidatamab (ZIIHERA): Jazz Pharmaceuticals |
|
10.12 |
Trastuzumab deruxtecan (ENHERTU): AstraZeneca and Daiichi Sankyo |
|
10.13 |
Tasurgratinib (TASFYGO): Eisai |
|
11 |
Emerging Biliary Tract Cancer Therapies |
|
11.1 |
Key Cross Competition |
|
11.2 |
Tinengotinib (TT-00420): TransThera Sciences |
|
11.2.1 |
Product Description |
|
11.2.2 |
Other Developmental Activities |
|
11.2.3 |
Clinical Development |
|
11.2.3.1 |
Clinical Trial Information |
|
11.2.4 |
Safety and Efficacy |
|
11.2.5 |
Analyst Views |
|
11.3 |
Rilvegostomig: AstraZeneca and Compugen |
|
11.4 |
Nanvuranlat (JPH203): J-Pharma/OHARA Pharmaceutical |
|
11.5 |
Tovecimig (CTX-009): Compass Therapeutics |
|
11.6 |
Lenvatinib mesylate (LENVIMA): Merck and Eisai |
|
11.7 |
Tucatinib (TUKYSA): Seagen/Pfizer |
|
11.8 |
BOLD-100: Bold Therapeutics |
|
11.1 |
VG161: Virogin Biotech |
|
12 |
BTC Market: 7MM Analysis |
|
12.1 |
Key Findings |
|
12.2 |
Biliary Tract Cancer Market Outlook |
|
12.3 |
Conjoint Analysis |
|
12.4 |
Key Biliary Tract Cancer Market Forecast Assumptions |
|
12.5 |
Total Market Size of BTC in the 7MM |
|
12.6 |
Total Market Size of BTC by Therapies in the 7MM |
|
12.7 |
The United States Biliary Tract Cancer Market |
|
12.7.1 |
Total Market Size of BTC in the United States |
|
12.7.2 |
Total Market Size of BTC by Therapies in the United States |
|
12.8 |
EU4 and the UK Biliary Tract Cancer Market |
|
12.9 |
Japan Biliary Tract Cancer Market |
|
13 |
Biliary Tract Cancer Market Unmet Needs |
|
14 |
Biliary Tract Cancer Market SWOT Analysis |
|
15 |
KOL Views on BTC |
|
16 |
Biliary Tract Cancer Market Access and Reimbursement |
|
16.1 |
The United States |
|
16.2 |
In EU4 and the UK |
|
16.3 |
Japan |
|
16.4 |
Summary and Comparison of Market Access and Pricing Policy Developments in 2025 |
|
16.5 |
Market Access and Reimbursement of BTC Therapies |
|
17 |
Bibliography |
|
18 |
Biliary Tract Cancer Market Report Methodology |

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