...a 38-year-old woman who presented with abdominal pain and was subsequently diagnosed with locally advanced intrahepatic cholangiocarcinoma…Analysis of the de novo assembly of the genome and transcriptome sequence data revealed a novel fusion of exon 2 of the ATP1B1 gene to exon 2 of NRG1...patient initiated afatinib at 40 mg orally per day but required a dose reduction to 30 mg daily due to skin rash and diarrhea...She maintained a response for 8 months and then developed new sites of metastases...could be identified as a clear mechanism to c.