The pivotal Advanced Biliary Tract Cancer (ABC) Trial established combination gemcitabine-cisplatin (gem-cis) therapy as the standard of care for patients with locally advanced and/or metastatic IHC. While the majority of patients experience initial disease stabilization after therapy (e.g. stable disease, partial response, or complete response) partial or complete response occurs in only approximately 20% of patients. Smaller trials comprising other chemotherapeutics with or without anti-biologic agents report similar results. Moreover, disease stabilization is short lived with median progression free survival of only six-eight months. Thus, there is a pressing need for more effective liver directed therapy for locally advanced disease.