ฺBiliary tract cancer is an uncommon
cancer in developed countries. There
are approximately 1200 new cases in the
United Kingdom1 and 9000 new cases in the United
States per year, although the incidence is increasing,
perhaps related to gallstone disease.2
Most patients have advanced disease at presentation
and relapse despite surgery.3 Although advanced
biliary tract cancer can have a response to
chemotherapy, there is no recognized standard
palliative regimen because no single randomized
study has ever been sufficiently robust to define
a schedule; fluoropyrimidines,4,5 cisplatin,6 and
gemcitabine7,8 have shown activity.