Targeted therapies for gallbladder cancer: an overview of agents in preclinical and clinical development

Abstract

ABSTRACT INTRODUCTION: Gallbladder cancer (GC) is a rare malignancy with a dismal prognosis. If it is diagnosed early enough, it can be cured by surgical removal. Unfortunately, only a small GC patient population can be amenable to surgery, though, with a high relapse rate. Conventional chemotherapy remains the golden standard for unresectable or metastatic GC, both in the first and second-line settings, even if leading to a fair outcome improved AREAS COVERED: In recent years, the concept of “precision medicine”, new potential molecular targets have been examined. In the present review, a general outline of the current first- and second-line chemotherapies is provided. New therapeutic possibilities are reviewed, particularly HER2, EGFR, VEGF, TKI, MEK and BRAF inhibitors, and immunotherapy. Furthermore, published clinical trials are utilized to analyze the principal drug effectiveness in GC. EXPERT OPINION: GC is characterized by vast cancer heterogeneity and individual’s efficacy to different drugs. The ongoing trials have the potentiality of reshaping the landscape of systemic treatments for GC in the very next years. Nowadays, amongst therapeutic combinations, the addition of ICIs to chemotherapy has yielded encouraging results needing confirmation. In the next future, systematic implementation of gene profiling and further explorations of combination therapies will likely change the treatment scenario.