Gemcitabine Hydrochloride and Cisplatin before Surgery or Radiation Therapy in Treating Patients with Intrahepatic Bile Duct Cancer That Can or Cannot Be Removed by Surgery

Inclusion Criteria

• Participants must have histologically confirmed intrahepatic cholangiocarcinoma (IHC) without evidence of extrahepatic metastasis within 3 months prior to study registration
• Participants must have measurable disease, defined as at least one lesion that can be accurately measured in at least one dimension (longest diameter to be recorded) as >= 20 mm with conventional techniques or as >= 10 mm with spiral computed tomography (CT) scan; participants with resectable disease must have a single tumor (with no satellite lesions) with a total diameter or longest dimension of =< 20 cm; patients with unresectable disease must have a total tumor diameter of < 20 cm and =< 3 lesions; satellite lesions defined as lesions =< 2 cm from the dominant lesion are permitted for participants with unresectable disease
• Patients are not allowed to receive prior surgery or chemotherapy for the IHC
• Expected survival must be three months or greater
• Eastern Cooperative Oncology Group (ECOG) performance status =< 2 (Karnofsky >= 70%)
• Absolute neutrophil count >= 1,500/mcL
• Platelets >= 100,000/mcL
• Total bilirubin =< 2.5 mg/dl
• Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase [SGOT])/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase [SGPT]) =< 5.0 X institutional upper limit of normal
• Creatinine within normal institutional limits or creatinine clearance >= 60 mL/min/1.73 m^2 for subjects with creatinine levels above institutional normal
• No other known active secondary primary malignancy
• If patient has underlying cirrhosis, only Child-Pugh classification Group A patients may be included in the resectable cohort of this study; for patients with unresectable disease, Child-Pugh classification Groups A and B are allowed; clinical assessment of ascites and encephalopathy is required; Child-Pugh classification must be determined for all study participants at the time of eligibility analysis; note albumin and prothrombin time (PT)/international normalized ratio (INR) are required for Child-Pugh classification; these laboratories (labs) should be drawn with the other labs required for eligibility analysis
• Women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study treatment; should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her treating physician immediately; female patients of child-bearing potential must indicate to their physician that they are not pregnant at the time of enrollment or have a negative serum pregnancy test
• Ability to understand and the willingness to sign a written informed consent document

Exclusion Criteria

• Participants who have had chemotherapy or radiotherapy for intrahepatic cholangiocarcinoma
• Participants receiving any other anti-cancer or investigational agents
• History of allergic reactions attributed to compounds of similar chemical or biologic composition to gemcitabine (gemcitabine hydrochloride) or cisplatin
• Women who are pregnant or lactating
• Participants with evidence of non-hepatic metastatic disease
• Local conditions or systemic illnesses which would reduce the local tolerance to radiation treatment, such as serious local injuries, active collagen vascular disease, etc.
• Participants with a serious medical illness which may limit expected survival to less than 3 months
• Participants with serious psychiatric illness or social situations which would limit adherence to study requirements
• Participants receiving any medications or substances that are strong inhibitors or inducers of cytochrome P450, family 3, subfamily A, polypeptide 4 (CYP3A4) are ineligible
• Patients who require anticoagulation should receive low-molecular weight or standard heparin and not warfarin
• Uncontrolled intercurrent illness including, but not limited to ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
• Pregnant women are excluded from this study; breastfeeding should be discontinued if the mother is treated with gemcitabine
• Individuals with a history of a different malignancy are ineligible except for the following circumstances; individuals with a history of other malignancies are eligible if they have been disease-free for at least 5 years and are deemed by the investigator to be at low risk for recurrence of that malignancy; individuals with the following cancers are eligible if diagnosed and treated within the past 5 years: cervical cancer in situ, ductal carcinoma in situ (DCIS), stage I prostate cancer, and basal cell or squamous cell carcinoma of the skin
• Human immunodeficiency virus (HIV)-positive individuals on combination antiretroviral therapy are ineligible; HIV-positive individuals on highly active antiretroviral therapy (HAART) will be considered eligible if they have demonstrated good compliance and have a cluster of differentiation (CD)4 count > 500
• Prior liver directed radiation
• Patients with peripheral neuropathy >= grade 2