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This ZSAB‑neoGOLP trial is one of the first randomized neoadjuvant studies in high‑risk resectable intrahepatic cholangiocarcinoma. Neoadjuvant GOLP (gem‑ox + lenvatinib + toripalimab) nearly doubled median event‑free survival, 18.0 vs 8.7 months—and significantly reduced early recurrence, with a strong EFS P<0.001. Two‑year overall survival (OS) numerically favored the neoadjuvant arm (79% vs 61%), though it didn’t cross the stringent interim boundary. Toxicity was manageable (≈28% grade ≥3 during neoadjuvant therapy) and surgery remained feasible, making this a compelling strategy for high‑risk intrahepatic cholangiocarcinoma (ICC) pending longer follow‑up and approval.