Abstract 148P
Background
Gallbladder carcinoma (GBC) poses a significant health burden globally, particularly in India.Most studies have analysed data for all billiary tract cancers (BTCs) including cholangiocarcinoma which have a better outcome then GBC.Their is limited data exclusively on GBCs.This study aimed to investigate the epidemiological, clinical characteristics, and treatment outcomes in advanced GBC.
Methods
We conducted an analysis of 100 GBC cases diagnosed between April 2022 and October 2023 in a tertiary care hospital in eastern India. Data were collected and analysed using descriptive and inferential statistics.
Results
The median age was 55 years with a female majority (62%) and most patients had a normal BMI. Cholelithiasis was associated in 64% patients. The commonest presentation was abdominal pain. The Majority of the patients were ECOG performance status (PS): 2 (66%) and 3 (17%). Liver was the most common site of metastases followed by non-regional lymph nodes. Her2 overexpression was seen in 12/55 (22%) patients and the incidence of high microsatellite instability (MSI-H) was only 2% (1/42). Pathogenic mutations in ERBB2, TP53, PIK3CA and SMAD4 were the commonest mutations identified on next generation sequencing (NGS). Gemcitabine and platinum-based doublet chemotherapy was the most used first line regimen. Anti- Her2 therapy with trastuzumab was added in the Her 2 -positive subset. Four (4%) patients were treated with immunotherapy. Response assessment was available for 71 patients with an overall response rate (ORR = complete response + partial response) of 36.6% and disease control rate (complete response + partial response + stable disease) of 59%. The median progression free survival for the entire cohort was 5.1 months (range 4-6 months) and the median overall survival was 9.9 months (range 4.4 – 15 months). Multifactorial regression analysis for survival did not yield any subgroup benefit in terms of ECOG PS, Her2 status, CA 19 -9 levels and the chemotherapy regimen used.
Conclusions
Patients with advanced GBC were predominantly females with normal BMI. Inspite of the poor PS and limited use of immunotherapy the ORR and survival outcomes in GBCs were comparable with recent data from clinical trials in BTCs.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.