Would you add durvalumab to gem+cis in a patient with recurrent cholangiocarcinoma after liver transplant?

I would not offer gemcitabine/cisplatin plus durvalumab to a patient with recurrent cholangiocarcinoma after a liver transplant. The added clinical benefit of durvalumab is modest, and the risk of a life threatening liver transplant rejection is high.

At this point, I would not without safety data abut losing the transplant data.