Ponatinib Hydrochloride in Treating Patients With Advanced Biliary Cancer With FGFR2 Fusions

PRIMARY OBJECTIVES: I. To assess the clinical benefit rate (confirmed complete or partial response or stable disease for 4 or more cycles) of ponatinib (ponatinib hydrochloride) in fibroblast growth factor receptor (FGFR) aberrant advanced biliary cancers. SECONDARY OBJECTIVES: I. To estimate progression free survival, overall survival, and cancer antigen 19-9 (CA19-9) response rate of these patients. II. To estimate the adverse event profile of ponatinib. TERTIARY OBJECTIVES: I. Establish preliminary correlations between FGFR2 fusions and evidence of any clinical benefit. II. Assess preliminary evaluation of FGFR2 pathway perturbation with ponatinib. III. To describe patient-reported health-related quality of life and symptoms. OUTLINE: Patients receive ponatinib hydrochloride orally (PO) once daily (QD) on days 1-28. Courses repeat every 28 days in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up every 6 months for at least 2 years.