 Hepatocellular carcinoma HCC is one of the most frequently diagnosed malignancies in some regions of the world, particularly Africa and the Asian portion of the Pacific rim. However, it is an uncommon malignancy in the United States, with less than 14,000 cases diagnosed annually. Malignancies of the gallbladder and biliary tree are also uncommon. As with most solid tumors, unless either neoplasm can be resected completely, the prognosis is grim. A variety of agents have been utilized in the therapy of HCC and cholangiocarcinoma, both as single agents and in combination regimens. However, despite response rates which exceed 50 when hepatic arterial therapy is utilized for HCC, response rates for cholangiocarcinoma and for systemic treatment of HCC are considerably lower. Long term survival remains uncommon. For this reason, new therapeutic approaches must be evaluated. 