Chemotherapy in biliary tract carcinomas: results in India

Epidemiology data from India suggest that biliary tract carcinomas occur primarily in the older population. Because of the absence of early symptoms, most patients present with advanced disease, and the outcome has been disappointing even in patients with resectable tumors who have undergone aggressive surgery. Although there is no standard therapy, data from recent clinical trials warrant further investigation of the role of chemotherapy in biliary tract carcinoma. In view of the favorable toxicity profile and observed efficacy of gemcitabine in advanced biliary tract cancers, its evaluation in combination with other active, potentially synergistic cytotoxic drugs such as cisplatin, capecitabine, and carboplatin should be studied with an aim to improve therapeutic efficacy and survival.