Molecular Profiling will tell you and your doctor about your tumour’s biomarkers. You might also hear it called “genomic testing”, “tumour testing” or “biomarker testing”.

Normally, this involves sending a sample of tissue (obtained via a biopsy or at surgery) to a laboratory for analysis.

If you are undergoing a biopsy, it is worth asking your doctor to ensure that enough tissue is obtained to facilitate molecular profiling.

In cases where a biopsy or surgery is not recommended, it may be possible to have some molecular profiling done via a blood test, this is sometimea known as a “liquid biopsy”.

There are different kinds of biomarker tests that will look only for specific biomarkers. To get a complete picture of the mutations or proteins that may be fueling your tumour, ask your doctor for Comprehensive Molecular Profiling.

To date, researchers have discovered that there are many biomarkers associated with cholangiocarcinoma. Each person with cholangiocarcinoma has some of these biomarkers.

Many of the biomarkers seen in cholangiocarcinoma are also seen in other types of cancer. That is especially important for cholangiocarcinoma patients because some of these other cancers have treatments that may also work in cholangiocarcinoma. In fact, there are many clinical trials going on that are studying the potential effects of these treatments on cholangiocarcinoma patients who have certain biomarkers.

That’s why your biomarkers matter!

More than 50% of patients with cholangiocarcinoma have at least one biomarker that can be treated with a known therapy. We call these biomarkers “actionable”.

Knowing which biomarkers are driving your individual tumour can help you and your doctor decide the best way to treat your cancer. It can also open the door to newer drugs and clinical trials that are only available to patients with specific biomarkers.

How is molecular profiling used?

• Diagnostic biomarkers can tell you and your doctor whether you have cancer and help determine the type and form of your cancer.

• Prognostic biomarkers help to tell you how likely a cancer is to come back or progress. They can also forecast how you are likely to do, with or without therapy.

• Predictive biomarkers can help to identify which therapies might work for your particular tumour and which might be wrong for you. These treatments may be:

• Approved therapies for cholangiocarcinoma,

• A therapy already approved to treat another cancer that is being studied in a clinical trial to see if it is effective in cholangiocarcinoma, or

• A therapy still in development that is being studied in a clinical trial.

In Ireland, molecular profiling is covered by all the major insurance companies for cholangiocarcinoma.

Unfortunately, as of January 2025, molecular profiling is still not provided by the HSE to public patients, although public patients can pay for it to be done privately.