For metastatic cholangiocarcinoma that has progressed on first line chemotherapy and immunotherapy, that is HER2 3+, which HER2 regimen is preferred, TDxD, Zanidatamab or tucatinib/trastuzumab?   

With the studies specific to cholangiocarcinoma with these agents and risk profile, I’d favor the bispecific Zanidatamab over the antibody drug conjugate T-DXd.Smolenschi et al., PMID 40319675The pneumonitis/ILD is still a black box warning for the ADC and varies between 5-15% depending on whi...