Gallbladder cancer
The 2022 Nature Reviews primer on gallbladder cancer: the commonest biliary cancer, mostly found by chance at gallstone surgery, driven by long-standing inflammation, curable only by surgery and badly in need of screening biomarkers and separate study.
Overview
Disease primer by authors from Chile, India, the United States and the US National Cancer Institute. Gallbladder cancer is the most common biliary tract cancer with a very poor prognosis at advanced stages; most cases are discovered incidentally after cholecystectomy for symptomatic stones, and chronic inflammation drives the disease whether or not stones are present. Omics studies have clarified inflammation-driven initiation and progression. Surgery is the only curative treatment and few cases are resectable; adjuvant therapy has low response rates. Unmet needs named: biomarkers for screening, therapy selection and prognosis; standardised nomenclature for preneoplastic lesions and specimen processing; and multidisciplinary care with neoadjuvant, adjuvant and novel systemic therapies including immunotherapy.
- Most gallbladder cancers are discovered incidentally after cholecystectomy for symptomatic gallstones.
- Named unmet needs: screening, selection and prognostic biomarkers; standardised lesion nomenclature and specimen sampling.
The best single starting point for a clinician or researcher new to the disease, written by the groups running the Chilean and Indian cohorts; its list of unmet needs is the skeleton of the ideas section on this page.
- Narrative review.
- Published before the zanidatamab approvals and the TOPAZ-1 long-term update.
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