Biliary tract cancers (BTC) include a heterogeneous group of aggressive tumours with an increasing incidence in Europe. Limited knowledge of risk factors and the lack of biomarkers for diagnosis are responsible for frequent late detection. These tumours are characterised by high refractoriness to conventional chemotherapy, and an unmet need for development of novel therapeutic strategies. Targeted therapies have proven to be a good option for only subgroups of patients, but their access is unevenly distributed across Europe, requiring urgent implementation plans for patients’ benefit.