Hi, Gavin,
This exactly what I was told by Dr. Gores at Mayo that even the majority of patient may not response to Sorafenib beyond the short period of time of benefit; a sub set of patients can be of benefit from Sorafenib (a TKI-tyrosine kinase inhibitor)for a long time to control the cholangiocarcinoma .
My guess is that other small molecules or antibodies (TKI & MoAB) will do the same. It just take time to find out the one that will be the best one to begin with. And NGS( next generation sequencing) gene profile will provide a foundation for such search if the oncologist is experienced on using this route.At this time, few treatments are really standing out,but at least better than going thru a lot of traditional chemotherapy without a personalized therapy in plan.
I knew doctors and others may not agree on using this new technology to search for treatment, but there is one big difference ,the medical professional are not patients like us,we have a time limit and they don’t.
Again, be sure to say hi to your mum for me, you are right , here in Chicago is as cold as the feet of the BEARS and the sky is cloudy, with no chance of going to playoff or meat ball.
God bless.