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Durvalumab or pembrolizumab combined with CisGem is already approved by the FDA and EMA in this indication and both are recommended by most national and international guidelines as first-line treatment in biliary tract cancer, especially taking into account that the 24-month survival rates in both studies are comparable (23.6% 308 versus 25% 310 , respectively)

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While antibiotics, and endocrine drugs, and metabolic therapies aim to promote health, they often face challenges such as pathogen resistance or detrimental side effects on the host