Biliary tracts cancers (BTCs) are a diverse group of aggressive malignancies with an overall poor prognosis. Genomic characterization has uncovered many putative clinically actionable aberrations that can also facilitate the prognostication of patients. As such, comprehensive genomic profiling is playing a growing role in the clinical management of BTCs. Currently however, there is only one precision medicine approved by the US Food and Drug Administration (FDA) for the treatment of BTCs. Herein, we highlight the prevalence and prognostic, diagnostic, and predictive significance of recurrent mutations and other genomic aberrations with current clinical implications or emerging relevance to clinical practice. Some ongoing clinical trials, as well as future areas of exploration for precision oncology in BTCs are highlighted.

胆道癌（BTC）是一组不同的侵袭性恶性肿瘤，总体预后较差。基因组表征发现了许多假定的临床上可操作的畸变，这些畸变也可以促进患者的预后。因此，全面的基因组分析在 BTC 的临床管理中发挥着越来越重要的作用。然而，目前只有一种精准药物获得美国食品和药物管理局（FDA）批准用于治疗 BTC。在此，我们强调复发性突变和其他基因组畸变的患病率以及预后、诊断和预测意义，这些畸变具有当前的临床意义或与临床实践的新兴相关性。重点介绍了一些正在进行的临床试验，以及 BTC 精准肿瘤学的未来探索领域。