Inclusion criteria
g/dLPatients, obstruction not impaired liver function, gall bladder carcinomaMeasurable, biliary drainage
DISEASE PROGRESSION, DISEASE, METASTATIC CHOLANGIOCARCINOMA, LIVER CIRRHOSIS, BILIARY OBSTRUCTION

Written informed consent incl. participation in translational research and any locally-required authorization (EU Data Privacy Directive in the EU) prior to performing any protocol-related procedures, including screening evaluationsAge ≥ 18 years at time of study entryHistologically or cytologically confirmed, non-resectable, locally advanced or metastatic cholangiocarcinoma or gall bladder carcinomaMeasurable or assessable disease according to RECISTDocumented disease progression after prior gemcitabine or gemcitabine containing therapy. Examples of permitted therapies include, but are not limited to: a) Single agent gemcitabine); b) Any gemcitabine-based regimen, with or without maintenance gemcitabineECOG performance status 0–1Ability to take medications orallyAdequate blood count, liver-enzymes, and renal function:ANC > 1,500 cells/μL without the use of hematopoietic growth factors; and Platelet count ≥ 100 × 109/L (> 100,000 per mm3) and Hemoglobin > 9 g/dL (blood transfusions are permitted for patients with hemoglobin levels below 9 g/dL)Serum total bilirubin ≤ 1.5 × upper normal limit (ULN) (biliary drainage is allowed for biliary obstruction; elevated bilirubin should be caused by obstruction not impaired liver function as assessed by albumin and INR values):Albumin levels ≥ 3.0 g/dLPatients not receiving therapeutic anticoagulation must have an INR < 1.5 ULN and PTT < 1.5 ULN within 7 days prior to inclusion. The use of full dose anticoagulants is allowed as long as the INR or PTT is within therapeutic limits (according to the medical standard in the institution) and the patient has been on a stable dose for anticoagulants for at least three weeks at the time of inclusion.AST (SGOT) and ALT (SGPT) ≤ 5 × institutional upper limit of normalSerum Creatinine ≤ 1.5 × ULN and a calculated glomerular filtration rate ≥ 30 mL per minute Adequate renal and bone marrow functionIn case of liver cirrhosis: Child–Pugh AWomen of childbearing potential must have a negative pregnancy test and must agree to adequate birth control if conception is possible. Males must agree to adequate birth control