Chemotherapy for Advanced Gallbladder Cancer (GBC): A Systematic Review and Meta-Analysis.

Abstract

BACKGROUND\nThe benefit from chemotherapy, specifically for patients with gallbladder cancer (GBC), has been poorly explored since GBC is mostly studied jointly with other biliary tract cancers (BTC).\n\n\nMETHODS\nEligible studies reporting outcome of palliative systemic chemotherapy for advanced GBC were identified through MEDLINE, cross-referencing and conferences (PROSPERO-CRD42019155745). Meta-analysis of proportions and calculation of pooled weighted means were performed.\n\n\nRESULTS\n58 eligible studies (n\u2009=\u20091,986 patients); cisplatin/gemcitabine (33% of patients), gemcitabine/oxaliplatin (14%) or gemcitabine monotherapy (9%). Estimated pooled overall radiological response rate(ORR), and pooled weighted mean progression-free (PFS) and overall survivals (OS) were 23.2% (95%-CI 20.0-26.5) (I2: 52.5% (p\u2009<\u20090.001)), 4.8 months (95%-CI 4.3-5.2) and 8.3 months (95%CI 7.6-8.9), respectively. Patients with non-GBC BTCs achieved a lower ORR than GBC [odds ratio 0.65 (95% CI, 0.50-0.84)].\n\n\nCONCLUSIONS\nGBC benefit from chemotherapy differs from other BTCs, with shorter PFS/OS despite higher ORR; new treatment options are urgently required for management of advanced GBC.