Floxuridine, Dexamethasone, Gemcitabine Hydrochloride with or without Oxaliplatin in Treating Patients with Liver Cancer That Cannot Be Removed by Surgery

Inclusion Criteria

• Histologically confirmed intrahepatic cholangiocarcinoma (also variously reported as peripheral cholangiocarcinoma, cholangiolar carcinoma or cholangiocellular carcinoma) (ICC); confirmation of the diagnosis at the Memorial Sloan-Kettering Cancer Center (MSKCC) or at the enrolling institution must be obtained prior to initiation of protocol therapy
• Clinical or radiographic evidence of metastatic disease to regional lymph nodes will be allowed, provided it is amenable to resection
• Radiographically measurable disease; measurable disease is defined as disease that can be assessed with 2-dimensional measurements on a cross-sectional imaging; minimum lesion size is 2 cm in greatest diameter as per Response Evaluation Criteria in Solid Tumors (RECIST) criteria
• Disease must be considered unresectable at the time of preoperative evaluation
• Presence of less than 70% liver involvement by cancer
• Patients may have failed ablative therapy
• Patients previously treated with systemic chemotherapy will be eligible
• Karnofsky performance status (KPS) >= 60% and be considered candidates for general anesthesia, abdominal exploration and hepatic artery pump placement
• Patients with chronic hepatitis and/or cirrhosis are eligible, but must be Child-Pugh class A
• Patients must be able to read, understand and sign informed consent
• White blood cells (WBC) >= 2,000 cells/mm^3
• Platelet count >= 75,000/mm^3
• Creatinine =< 1.8 mg/dl
• Total bilirubin < 1.5 mg/dl

Exclusion Criteria

• Presence of distant metastatic disease; patients will undergo radiographic evaluation to exclude the possibility of distant metastatic disease; for patients who have undergone pre- or postoperative biopsies that definitively diagnose ICC, the diagnostic studies may be modified at the discretion of the MSKCC principal investigator; clinical or radiographic evidence of metastatic disease to regional lymph nodes will be allowed, provided it is amenable to resection
• Prior treatment with floxuridine (FUDR)
• Prior external beam radiation therapy to the liver
• Diagnosis of sclerosing cholangitis
• Clinical evidence or portal hypertension (ascites, gastroesophageal varices, or portal vein thrombosis; surgically related ascites does not exclude the patient)
• Active infection
• Pregnant or lactating women
• History of other malignancy within the past 3 years (except non-melanoma skin cancer)
• Life expectancy less than 12 weeks
• Inability to comply with study and/or follow up procedures
• History of peripheral neuropathy; (note: this does not apply to Cohort 3)