Downsizing of Unresectable Cholangiocarcinoma by Combined Intravenous and Intra-arterial Chemotherapy

Inclusion criteria: * Histologically or cytologically proven cholangiocellular carcinoma including gallbladder cancer. * Non-resectable cholangiocellular carcinoma as judged within an interdisciplinary tumor-board including senior hepatobiliary surgeons. Non- resectability is based on insufficient remnant liver volume. * Patient is not a candidate for liver transplantation * WHO Performance Score 0 or 1 * No extrahepatic tumor, as evaluated by PET/CT scan of the chest and the abdomen/pelvis with the exception of potentially resectable small lung nodules or hilar lymph node involvement. * The assessment is done within 21 days before registration. * Adequate liver function or kidney function tests, including any of the following: * Bilirubin \< 2 x ULN * Aspartate-Aminotransferase (AST) \< 5 x ULN * Alanine-Aminotransferase (ALT) \< 5 x ULN * Alkaline phosphatase \< 5 x ULN * Estimated creatinine clearance \> 60 ml/min (using the Cockcroft formula) * Adequate hematological values: * Hemoglobin \> 80 G/L * Leucocytes \> 3.00 G/L, * Neutrophils \> 1.00 G/Ll * Platelets \> 100 G/L * Signed written informed consent * Patient age \>/= 18 years * Presentation of the case at the interdisciplinary tumor-board attended by hepatobiliary surgeons, oncologists, hepatologists and radiologists * Women who are not breastfeeding and are using effective contraception if sexually active, who are not pregnant and agree not to become pregnant during the 12 months thereafter. A negative pregnancy test before inclusion into the trial is required for women \< 50 years. * Men who agree not to father a child during participation in the trial or during the 12 months thereafter. * Patient compliance and geographic proximity allow proper staging and follow- up. Exclusion criteria: * Anatomic variant in arteriogram which prevents selective delivery of the chemotherapy to the liver * Life expectancy \< 3 months * Severe medical or psychiatric co-morbidity prohibiting the planned treatment or the giving of informed consent * Any man or woman of childbearing age in case of inadequate contraception * Pregnancy or breastfeeding woman * Known hypersensitivity to trial drugs or hypersensitivity to any other component of the trial drugs. * Treatment in clinical trial within 30 days prior to trial entry. * Active heart disease defined as congestive heart failure \> NYHA class 2 * Past or current history (within the last 2 years prior to treatment start) of other malignancies except basal and squamous cell carcinoma of the skin or in situ carcinoma of the cervix * Inability or unwillingness to comply with the study protocol