Just for clarification purpose only:
I do think it matters if you know what pathway inhibition is the best to start for treating the CCA that a patient has, especially if drug resistance will be developed down the road which are quite common for TKI . Besides the adverse drug reactions are different( ie: some are more prone to the cardiac toxicity and others are prone to the GI toxicity.) ,Also, it does make a difference if patient has comobidities ( patient has other health problems,like a cardiac patient or a diabetic patient.)
My point is to encourage patients ,when if they can, follow the top hospitals practices to obtain a " next generation sequencing genomic profile" for them to map out the best personalized treatment plans for them now or in the future planning of recurrence. ( This is my own conclusion after oncology consult with three oncologists whose names are very familiar with our members on this discussion board.)
In my opinion, not all the oncologists ( esp The community or locally practices ones )are familiar with most of this new types TKI or immunotherapy agents( IA) that came out of the market in the last couple years, therefore ,without experience or 2nd opinion to support the "off label use" of this new TKI or IA, I do not think it is that easy to ask them for a prescription and I don't think it is appropriate for them to do so either.
Please know that my personal opinion is not intended nor implied to be a substitute for professional medical advice. If provided, information are for educational purposes.Consult doctor is a MUST for changing of treatment plans.