 The only curative option for patients with gallbladder- or bile duct cancer is surgical resection. Advanced CCA has a devastating prognosis. There are only limited numbers of studies about the systemic treatment options for biliary cancers. Gallbladder and bile duct carcinomas are moderately chemotherapy-sensitive tumors. The objective response rates in phase II studies with 5-FU or gemcitabine monochemotherapy are between 10 - 30 Kubicka et al. 2001b. Higher response rates between 20 - 50 have been observed in phase II studies with combination chemotherapy, in particular with the combination of gemcitabinecisplatin Kubicka 2004; Malek et al. 2007. 