Report from the 26th Annual Western Canadian Gastrointestinal Cancer Consensus Conference on Hepatocellular and Biliary Tract Cancer, Saskatoon, Saskatchewan, 17–18 October 2024

This paper provides recommendations for healthcare professionals involved in the care of patients with hepatocellular and biliary tract carcinoma based on current published criteria. Patients should be assessed by a multi-disciplinary team. Surgically, achievement of functional liver remnant with negative margins is important for all resection cases. Patients should be counselled prior to molecular testing as mutations may not be actionable. Actionable mutations for biliary tract cancer include HER2, BRAF V600E, NTRK fusion, and RAS. DNA mismatch repair (MMR) is recommended for all patients. Combination therapy (bevacizumab and atezolizumab) or immunotherapy are preferred first-line options for advanced hepatocellular carcinoma (HCC). Further studies are required to prove if a combination of local and systemic therapy can be utilized widely in patients with intermediate-risk HCC. For biliary cancers, a combination of platinum, gemcitabine, and immunotherapy with durvalumab or pembrolizumab is the optimal systemic treatment, if available.