Onc's don't know everything. Mine pushed me into FOLFOX6 which basically did nothing - at best it may have held things stable for a few months, which is good news.
My FoundationOne report identified some genomic alterations. Since the FOLFOX is no longer working, my onc has no further options for me in the way of treatment. However, a new onc at the Cleveland Clinic has identified a clinical trial that he is conducting that I may be eligible for. I did the pre-screening but there is a problem with low platelets. I go for re-test April 6. If things are good, I start April 13. (In fairness to my current onc, she identified the "brand new" trial after I had been in contact with the Cleveland Clinic.)
Kevin, you have to make the best decisions you can at the time, based on what you know. CCA develops a resistance to chemo treatments. Sometimes not just one at a time, but broader. The commonality between my chemos is a platin-based chemical. Whether it's cisplatin, carboplatin, or oxaliplatin, I think CCA develops a resistance faster with each new chemical. They are paired with other chemicals (gemzar, 5FU) which may help extend their usefulness, but nothing works forever. By bringing in the SIRT you were giving a new form of treatment a chance.
When the Foundation report comes back, it will list a few ongoing trials. If none are available to you, keep searching the Trials section here to find out what is coming out. Plus, Gavin is invaluable at posting new stuff. Watch his new posts.
After carbo/gem stopped working for me, my onc put me on gem alone which worked well for many months.
Experience of the doctors with CCA is of paramount importance. I was (maybe) the second one my onc had ever treated. The whole center had only treated four in three years. No second opinions there. Don't underestimate the value of a second opinion.
Hang in there. We are all pulling for you and your mum.