Phase II Trial of Nab-Paclitaxel and Gemcitabine for First-Line Treatment of Patients With Cholangiocarcinoma

Inclusion Criteria: * Must have histologically-confirmed diagnosis of cholangiocarcinoma Stage II, III, or IV CCA (intra-hepatic, extra-hepatic and perihilar) that is not eligible for curative resection, transplantation, or ablative therapies. Tumors of mixed histology are not allowed. * Must have radiographically measurable disease in at least one site not previously treated with radiation, chemoembolization, radioembolization, or other local ablative procedures; a new area of tumor progression within or adjacent to a previously-treated lesion, if clearly measurable by a Radiologist, is acceptable. * May have received prior radiation, chemoembolization, radioembolization, or other local ablative therapies, or hepatic resection if completed ≥ 4 weeks prior to registration AND if patient has recovered to ≤ grade 1 toxicity. NOTE: Measurable disease (as required above) must still be present. * May have received prior radiation for bone or brain metastases if patient is now asymptomatic and has completed all radiation and steroid therapy (if applicable) ≥ 2 weeks prior to registration. * Age ≥ 18 years. * Child-Pugh score of A or B with ≤ 7 points. * Eastern Cooperative Oncology Group performance status of 0-1. * Willing to provide archived tissue, if available, from a previous diagnostic biopsy. * Must be able to tolerate CT and/or MRI with contrast. * Adequate organ function obtained ≤ 2 weeks prior to registration: * Absolute Neutrophil Count ≥ 1500/mm³ * Hemoglobin ˃9.…