Because the patient's tumor IHC profile (CK7 positivity) was consistent with pancreatobiliary‐type ampullary adenocarcinoma, therapy was switched to gemcitabine 400 mg/m2 and nab‐paclitaxel 125 mg/m2, given once every 10 days. The gene discussed is KRT7; the disease is ampulla of vater adenocarcinoma.