New life-extending treatment given the green light for people with rare form of bile duct cancer
A new targeted treatment for a rare and aggressive form of bile duct cancer has been recommended by NICE for routine use on the NHS in England, giving people more time with better quality of life.

NICE has recommended zanidatamab, also known as Ziihera and made by Jazz Pharmaceuticals, in final draft guidance for adults with HER2-positive advanced biliary tract cancer - a group of cancers affecting parts of the body that store and transport bile, including the bile ducts and gallbladder, who have already received at least one treatment.
Biliary tract cancer is often diagnosed late, when it can no longer be removed by surgery. Fewer than one in three people in England survive for a year after diagnosis, and until now, treatment options for patients whose cancer had progressed were limited.
Around 65 people a year in England are expected to be eligible for zanidatamab, which is given by an intravenous infusion once every two weeks.
It works by recognising and attaching to a protein called HER2 found on the surface of cancer cells and slows or stops the cancer cells from growing.
Clinical trial data showed that people treated with zanidatamab lived for an average of 18 months after taking the drug, significantly longer than those receiving standard chemotherapy, which was around six months.
Unlike the standard chemotherapy treatment for advanced biliary tract cancer (known as FOLFOX), zanidatamab does not have to be given through a surgically implanted device that can cause side effects including pain, exhaustion, and nerve damage.
I am pleased we have been able to recommend this effective new treatment option, the first HER2-targeted drug NICE has recommended for people with biliary tract cancer in England. Patients and clinical experts involved in the appraisal told us how this treatment would make a huge difference by extending people’s lives and improving their quality of life - something that was not always possible with chemotherapy.
We are determined to ensure NHS patients in England have access to the most promising new treatments while providing value for the taxpayer.
AMMF welcomes NICE’s positive recommendation of zanidatamab. Until now, people with HER2-positive cholangiocarcinoma (bile duct cancer), gallbladder cancer, or ampullary cancer whose disease had progressed on first-line therapy had no targeted treatment options. During NICE’s appraisal, we heard from patients and their families about the positive difference zanidatamab provided for them. We are therefore pleased that more people with advanced HER2-positive disease will be able to access this life-extending treatment through the NHS.
Cancer diagnosis can turn a family’s world upside down, and people diagnosed with this rare and aggressive cancer have had so few options for so long. Thanks to these changes more people will have precious extra time with the people they love. Through the National Cancer Plan, this government is committed to making sure NHS patients get access to the best new treatments, and today’s recommendation delivers exactly that.
Read the final draft guidance for zanidatamab for treating HER2-positive advanced biliary tract cancer after 1 or more lines of systemic treatment.