A Study of Ramucirumab (LY3009806) or Merestinib (LY2801653) in Advanced or Metastatic Biliary Tract Cancer

Inclusion Criteria:

- Have an Eastern Cooperative Oncology Group performance status of 0 or 1.

- Have a histologically or cytologically confirmed diagnosis of non-resectable,
recurrent, or metastatic biliary tract adenocarcinoma (intrahepatic or extrahepatic
cholangiocarcinoma, gallbladder cancer, or Ampulla of Vater) .

- Have measurable disease by Response Evaluation Criteria in Solid Tumors (RECIST).

- Have adequate biliary drainage.

- Have adequate organ function.

- Males and females are sterile, postmenopausal, or compliant with a highly effective
contraceptive method.

- Female participants of childbearing potential must have a negative serum pregnancy
test within 7 days prior to first dose.

- Are willing to provide blood/serum/plasma and tumor tissue samples for research
purposes. Submission of blood/serum/plasma and tumor tissue samples is mandatory for
participation in this study, unless restricted per local regulations.

Exclusion Criteria:

- Previous systemic therapy for locally advanced or metastatic disease is not allowed.

- Have a history of or have current hepatic encephalopathy of any grade, or ascites of
Grade >1, or cirrhosis with Child-Pugh Stage B or higher.

- Have ongoing or recent (≤6 months) hepatorenal syndrome.

- Have had a major surgical procedure or significant traumatic injury including
nonhealing wound, peptic ulcer, or bone fracture ≤28 days prior to randomization.

- Anticipate having a major surgical procedure during the course of the study.

- Has documented brain metastases, leptomeningeal disease, or uncontrolled spinal cord
compression.

- Within 6 months prior to randomization, have had any arterial thrombotic event,
including myocardial infarction, unstable angina, cerebrovascular accident, or
transient ischemic attack.

- Have an uncontrolled arterial hypertension with systolic blood pressure ≥150 or
diastolic blood pressure ≥90 millimeters of mercury (mm Hg) despite standard medical
management.

- Have a previous malignancy within 5 years of study entry or a concurrent malignancy.

- Have a history of gastrointestinal perforation and/or fistulae within 6 months prior
to randomization.

- Have a known allergy or hypersensitivity reaction to any of the treatment components.

- Have a history of uncontrolled hereditary or acquired thrombotic disorder.

- Have uncontrolled metabolic disorders or other nonmalignant organ or systemic diseases
or secondary effects of cancer that induce a high medical risk and/or make assessment
of survival uncertain.

- Have mixed hepatocellular biliary tract cancer histology.

- Have a corrected QT interval >470 milliseconds as calculated be the Fredericia
equation.