Use of gemcitabine in gallbladder cancer.: Report of four cases

Surgery continues to be the only curative therapy for gallbladder cancer, but useful in very few patients. Mean survival of patients with gallbladder cancer, that are out of the reach of surgery, is 3 months. The few clinical trials of chemotherapy for this disease, report very low success rates. We report four patients with advanced gallbladder cancer, treated with gemcitabine in an intravenous dose of 1000 mg/m2, given in 30 min, once a week during three consecutive weeks, every 28 days. There was a partial response that lasted 40,3 23,2 weeks with a mean survival of 59,75 17 weeks. One patient survives without evidences of disease after 17 months of the diagnosis of an advanced cancer. In all patients, symptoms were alleviated, functional status and quality of life improved. Toxicity was mild and did not require reduction in doses or delay in therapy. Therefore, this medication deserves further investigation for the treatment of gallbladder cancer.