After a decade without any improvement in treatment for bile duct cancer, the National Institute for Health and Care Excellence has approved a new drug, pemigatinib. The drug will be an option to treat people if cancer continues to spread after initial chemotherapy. Bile duct cancer (cholangiocarcinoma) is a rare type of cancer and, until now, there have been no effective treatments available on the NHS. The drug represents a new hope for patients and we are pleased to see that advances are being made to treat rare cancers in the UK.