Neoadjuvant therapy in gall bladder cancer improves resectability and survival: a prospective study

Area of Science:

• Oncology
• Surgical Oncology
• Chemotherapy

Background:

• Gallbladder carcinoma presents a poor prognosis with limited resectability at diagnosis.
• The efficacy of neoadjuvant chemotherapy (NACT) for gallbladder cancer is not well-established.

Purpose of the Study:

• To evaluate the impact of NACT on resectability and survival outcomes in patients with gallbladder carcinoma.
• To assess the safety and feasibility of NACT in a prospective clinical setting.

Main Methods:

• A prospective, single-center study involving 226 patients with gallbladder carcinoma.
• Patients received gemcitabine-platinum-based NACT followed by response assessment.
• Primary endpoints included achieving resectability and overall survival.

Main Results:

• The intention-to-treat resection rate was 36.2%, increasing to 60.7% among those completing NACT.
• R0 resection was achieved in 95.1% of resected patients.
• Median overall survival was 27 months for resectable versus 13 months for unresectable cases (p < 0.001).
• Grade ≥3 toxicity occurred in 9.7% of patients, with a 1.7% treatment-related mortality.

Conclusions:

• NACT significantly enhances curative resection rates in gallbladder cancer patients completing treatment.
• The findings support the integration of NACT into treatment strategies for locally advanced gallbladder cancer.
• NACT demonstrates acceptable toxicity profiles and improved survival outcomes.