Intrahepatic cholangiocarcinoma (ICC) is a highly malignant neoplasm. The incidence of ICC has been increasing world-wide over the past several decades. Areas covered: The pathogenesis of ICC is a complex process involving the alteration of specific genes and epigenetic changes. This review summarizes the advances in research of gene alterations and epigenetic changes in ICC; it also aims to promote the findings of new biomarkers that can be used to diagnose ICC and to provide novel ideas for the combination of molecular targeted therapies. Expert commentary: Surgical resection is regarded as the most effective curative treatment, although in many cases, resectability and curability are unsatisfactory. Furthermore, many patients are diagnosed at advanced stages and have to resort to chemotherapy, which is rarely curative. Many of the molecular mechanisms of ICC are yet to be determined; once these determinations are made, then ICC may be able to be treated by precise targeted drugs.
Keywords: Intrahepatic cholangiocarcinoma (ICC); epigenetic changes; gene alterations; molecular targeted therapies; precision medicine.