What is your preferred first line therapy for metastatic cholangiocarcinoma, if the patient is cisplatin ineligible or cisplatin is unavailable?

While there is a lack of direct comparative trials, the whole development of the platinum drugs suggests oxaliplatin should be equally or more active for GI cancers.

I would, therefore, use Gem-Ox, a very active regimen for pancreatic cancer, studied in phase 3 trials. Alternatively, gem-carboplatin...

This question comes at the time of a very unfortunate and unacceptable time of severe drug shortage problem involving both cisplatin and carboplatin which can modify and make the question more relevant as “What is your preferred first line therapy for a metastatic cholangiocarcinoma patient who is r...