What's New in Gallbladder Cancer Research?

Because gallbladder cancer is rare, it's been hard to study it well. Most experts agree that treatment in a clinical trial should be considered for any stage of gallbladder cancer. This way people can get the best treatment available now and may also get the treatments that are thought to be even better.

Gallbladder cancer research is being done in many university hospitals, medical centers, and other institutions around the world. Each year, scientists find out more about what causes the disease, how to prevent it, and how to better treat it. The new and promising treatments discussed here tend to only be available in clinical trials.

Diagnosis

Because gallbladder cancer is often found after surgery to remove the gallbladder for other problems (like gallstones), doctors are looking for ways to know whether gallbladder problems are cancer before surgery is done. For instance, studies are looking at how to better use imaging tests, like ultrasound and CT scans, to more accurately identify and diagnose changes in the gallbladder. Identifying proteins that are linked to gallbladder inflammation is another area of research. Early research has suggested that high levels of certain proteins in the blood may help show which people have gallstones and which have cancer. This could even be used as a screening test in the future, but a lot more research is needed.

Radiation therapy

Researchers are looking for better ways to use radiation therapy, as well as how to best use it along with other treatments, like surgery and chemotherapy. Using certain chemo drugs and radiation together has been found to work better than either treatment alone. This is called chemoradiation. The timing of these 2 treatments, as well as which drugs work best with radiation to treat gallbladder cancer are of great research interest.

Doctors are also studying other ways to use radiation therapy. For instance, some researchers are testing radioactive stents that are put inside bile ducts They might help shrink tumors and keep the ducts open longer than standard stents.

Chemotherapy

In general, chemotherapy (chemo) has been found to be of limited use against gallbladder cancer, but new drugs and new combinations of drugs are being tested. Studies are also looking for better ways to combine chemo with other treatments, like surgery and radiation.

There's a lot of research interest in combining chemotherapy and targeted therapy.

Targeted therapy

These drugs work differently from standard chemo drugs. They can target specific changes in cancer cells that help them grow and survive. They can also change certain proteins made by the cancer cells to cause the cells to die. Targeted drugs can work with the immune system to help it find and kill cancer cells, too. Many of these drugs are being tested for use in treating gallbladder cancer.

Many other kinds of cancers are already treated with targeted therapy. As researchers learn more about the changes in gallbladder cells that cause them to become cancer, they're looking to use targeted drugs that focus on killing the cells with these changes.

For instance, some of these drugs target tumor blood vessels. Gallbladder tumors need new blood vessels to grow beyond a certain size. Bevacizumab (Avastin^®), erlotinib (Tarceva^®), and regorafenib (Stivarga^®) are examples of drugs that target blood vessel growth and are being studied against gallbladder cancer.

Other drugs have different targets. For example, EGFR, a protein that helps cells grow, is found in high amounts on some cancer cells. Drugs that target EGFR have shown some benefit against many types of cancer. Some of these drugs, such as cetuximab (Erbitux^®) and panitumumab (Vectibix^®) are now being studied for use in people with gallbladder cancer, often in combination with chemotherapy or other targeted drugs.

Other types of targeted therapy, such as MEK inhibitors (like trametinib [Mekinist^®] and selumetinib ), and anti-PD1 drugs (like pembrolizumab [Keytruda^®]), are also being studied for use against gallbladder cancer.

Again, this is an active area of research, but a lot more research is needed to find out if targeted therapy works and which drugs work best in treating gallbladder cancer.