NICE has recommended zanidatamab, also known as Ziihera and made by Jazz Pharmaceuticals, for routine use on the NHS in England for adults with HER2-positive advanced biliary tract cancer who have already received at least one treatment. The decision, announced on 21 April 2026, is expected to give eligible patients more time and better quality of life.
Why the decision matters for a hard-to-treat cancer
Biliary tract cancer is often diagnosed late, when surgery is no longer possible, and treatment options have been limited for people whose disease has progressed. NICE said fewer than one in three people in England survive for a year after diagnosis, underlining the seriousness of the disease and the need for new options.
Around 65 people a year in England are expected to be eligible for zanidatamab, which is given by intravenous infusion once every two weeks. The recommendation means the treatment can now be offered in the NHS setting for patients with advanced HER2-positive disease after prior therapy.
A targeted treatment for a specific patient group
The guidance is aimed at adults with HER2-positive advanced biliary tract cancer, including cancers affecting parts of the body that store and transport bile, such as the bile ducts and gallbladder. NICE said the drug offers a new option for people facing a disease with few alternatives once it has spread or returned.
According to NICE, the treatment is intended for people who have already had at least one treatment. The aim is not only to extend life, but also to improve the quality of that time for patients living with a rare and aggressive cancer.
The new recommendation follows a series of recent NHS and NICE decisions aimed at improving access to specialist treatments for serious conditions. For more information, see the official NICE announcement at NICE.
As clinicians continue to look for better ways to treat advanced biliary tract cancer, the latest guidance adds another targeted option to the NHS toolkit. For patients and families confronting a diagnosis that is often found too late, that can make a meaningful difference.
