Background: Due to the high mortality rates from gallbladder carcinoma in C
hile, we conducted a phase II trial to test the efficacy and safety of gemc
itabine in patients with locally advanced or metastatic gallbladder carcino
ma.
Patients and methods:From January 1998 to February 2000, 26 patients with m
etastatic or unresectable gallbladder carcinoma and no prior chemotherapy r
eceived gemcitabine 1000 mg/m(2) over 30 minutes weekly for three weeks fol
lowed by a week of rest.
Results: Patients received a median of 4.2 cycles (range 1-10). Out of the
25 patients whose response could be evaluated, 9 went into partial remissio
n, an overall response rate of 36% (95% confidence interval (95% CI): 17.1%
to 57.9%). In six (25.0%) patients, the cancer remained stable, and in 10
(40%) it progressed. Median survival time was 30 weeks (range 7 - 80+). Hem
atological toxicities were mild, with no cases of febrile neutropenia or he
morrhage. However, four and one patient(s) had grades 1-2 and 3-4 neutropen
ia, respectively, and two patients had grade 2 thrombocytopenia. Nine patie
nts experienced grade 1-2 nausea/vomiting, but were able to continue treatm
ent. There were no toxic deaths.
Conclusions: In this phase II trial, gemcitabine is an active chemotherapy
in metastatic or inoperable gallbladder carcinoma, with a manageable toxici
ty profile.