Changing treatment

Hi,
I am sorry I can not answer to you faster today due to the fact that I am in Seattle visiting and only can check messages when the wifi are available in each hotels at nite.To give you some feed back about the medication or targeted agents is not difficult.
It is not a really big thing if the tumors grows only in < 4mm. In some case this tiny increase measure is not 100% accurated from reading directly from different monitors from the radiologist's office.
Since you will be started on the same chemo agents like 5fu and irinotecan,
The difference is of whether you should use Tarceva or verlaparib.
Tarceva isFDA approved to treat pancreatic cancer and it is also used in bile duct cancer in ” off the label” treatment with acceptable result . Verlaparib is a A PARA enzyme inhibitor, it has to work with other chemo agents to be more effective in killing the cancer,it Is a new agent used in clinical trial mostly and has not been approved by FDA in treating bile duct CA but doctors have the right to use and test the drug in ” off the label” treatment. It shows activity in solid tumors ( ie:breast CA when used with other chemo agent and in peritoneal tumors.)
In general, most the targeted agents like Tarceva and Nexavar, which you were on for 18 month,will be very effective at first ,then drug resistances developed and undermined their long term usefulness and effective.
I actually like to use Tarceva as my choice, since most of the side effects of the verlaparib are still not completely known. I remembered my sister-in-law tried a new drug called Md2206 and developed hyperglycemia And had to stopped the trial.
Please know that I am not a doctor and the above statement is at best, my best educational guess only. If you are lucky that you can choose ; I will suggest to follow you gut instinct which I believe it is sometimes ,if without emotion, is The Holy Spirit working on us and show us the way.
God bless.