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Gallbladder cancer research

Men and women discussing gallbladder cancer

This page of the gallbladder cancer section is about research into the causes, prevention and treatment of gallbladder cancer.

 

A quick guide to what's on this page

Gallbladder cancer research

All treatments must be fully researched before they can be adopted as standard treatment for everyone. This is so that we can be sure they work better than the treatments we already use. And so we know they are safe.

First of all, treatments are developed and tested in laboratories. Only after we know that they are likely to be safe to test are they tested in people, in clinical trials. Cancer Research UK supports a lot of UK laboratory research into cancer and also supports many UK and international clinical trials.

Unfortunately, there are not that many trials for gallbladder cancer treatment in the UK as it is not a common cancer in this country.

There is research going on looking into new tests, combining treatments, chemotherapy, biological therapies and photodynamic therapy.

 

CR PDF Icon View a summary of treating gallbladder cancer.

 

 

Why research is important

All treatments have to be fully researched before they can be adopted as standard treatment for everyone. This is so that

  • We can be sure they work
  • We can be sure they work better than the treatments that are available at the moment
  • They are known to be safe

First of all, treatments are developed and tested in laboratories. For ethical and safety reasons, experimental treatments must be tested in the laboratory before they can be tried in patients. If a treatment described here is said to be at the laboratory stage of research, it is not ready for patients and is not available either within or outside the NHS. Cancer Research UK supports a lot of UK laboratory research into cancer.

Tests in patients are called clinical trials. Cancer Research UK supports many UK and international clinical trials.

Our trials and research section explains about the 4 stages of clinical trials. You can also look on the clinical trials database to find out about trials for gallbladder cancer. If there is a trial you are interested in, print it off and take it to your own specialist. If the trial is suitable for you, your doctor will need to make a referral to the research team. The database also has information about closed trials and trial results. Clinical trials often combine bile duct cancer with gallbladder cancer. Together these are called cancers of the biliary tract.

All the new approaches covered here are the subject of ongoing research. Until studies are completed and new effective treatments are found, these potential new treatments cannot be used as standard therapy for cancer of the gallbladder.

Here is a video on what it's like to take part in a clinical trial:

View a transcript of the video (Opens in a new window)

 

New tests for gallbladder cancer

There are various tests used to diagnose gallbladder cancer. A new test is being researched that may help doctors be sure of the diagnosis. It is called the Mcm5 protein test, and the Mcm stands for minichromosome maintenance protein. There is a trial is looking at the Mcm5 protein test. It will find out how accurate and reliable this test is and how good it might be at helping to diagnose cancer. 

Another study is looking at a type of test called SPECT CT to help diagnose liver tumours, gallbladder cancers and bile duct cancers. The test is a combination of a CT scan and a SPECT scan. It uses a radioactive tracer which is taken up by liver cancer cells.  Doctors want to know whether the SPECT CT scan is better than the scans they already use. This study has now closed and we are waiting for the results.

 

Combining treatment

We know that the best way to treat gallbladder cancer that can be removed is surgery. But if your cancer has grown too far to be removed with surgery, or if it has come back, your specialist may suggest treatment with chemotherapy and radiotherapy. Radiotherapy can help to control gallbladder cancer to some extent, but not as much as doctors would like. Researchers have been trying to improve results by using radiotherapy and chemotherapy together.

Trials have looked into using combined chemotherapy and radiotherapy before or after surgery. This is still experimental and if your specialist suggests this, it should be as part of a clinical trial. The aim of the treatment is to lower the risk of the cancer coming back. Doctors have hoped that combined treatment before surgery could shrink an inoperable tumour and make it possible to remove. This sort of combined treatment can have quite severe side effects and we still don’t know if the increase in side effects is outweighed by any extra benefit in stopping the cancer coming back. We are not aware of any UK trials into combined chemoradiation before or after surgery for gallbladder cancer that are open at the moment.

 

Chemotherapy drugs

Doctors are constantly looking at new ways of using chemotherapy drugs that are known to work for most types of cancer. They study different combinations of drugs, different doses, or give them in different sequences. Some of the chemotherapy drugs that have been tried for gallbladder cancer include

You can click on the links above to find out more about these individual drugs and their side effects. The combination of gemcitabine and cisplatin chemotherapy is now often used to treat gallbladder cancer. In 2010 the results of a UK trial were published. The trial compared gemcitabine with gemcitabine and cisplatin for advanced cancer of the gallbladder or bile duct. The researchers found that the combination of gemcitabine and cisplatin worked better than gemcitabine alone. And it didn’t cause any more side effects. 

A trial is looking at oxaliplatin and 5FU for advanced gallbladder cancer. The researchers want to know whether these chemotherapy drugs help people who have already had another type of chemotherapy. And another trial is looking at capecitabine after surgery for gallbladder cancer to see if it helps prevent the cancer coming back. 

 

Biological therapy

Biological therapy is treatment with natural substances that the body makes to fight disease. There is more about biological therapy in our cancer treatments section.  A phase 3 clinical trial (called ABC 03) is looking to see if adding the biological therapy cediranib to the chemotherapy drugs gemcitabine and cisplatin works better than gemcitabine and cisplatin alone. Cediranib is a VEGF receptor inhibitor. The phase one trial called ABC 04 is looking to see if adding the biological therapy selumetinib to gemcitabine and cisplatin works better that these 2 drugs alone. Selumetinib is an MEK inhibitor. These trials are no longer recruiting patients, and we are waiting for the results. 

Outside the UK there are several early phase trials to see if other biological therapies might be helpful. These include erlotinib, sorafenib, bortezomib and bevacizumab.

 

Photodynamic therapy (PDT)

Photodynamic therapy is used for a few types of cancer. For gallbladder cancer, it is used to relieve symptoms, such as jaundice. Some small studies have used PDT alone versus PDT with a stent in place. The results have been promising for PDT alone. This treatment is to help relieve symptoms, not to try to cure cancer of the gallbladder. A phase 3 trial is looking into PDT to treat symptoms of gallbladder cancer that can't be removed with surgery. It is comparing PDT with a stent, to using a stent on its own. This trial has now closed and we are waiting for the results.

 

Quality of life

It is important to research how symptoms of gallbladder and bile duct cancer and side effects of treatment affect people's quality of life. There is a study to test a quality of life questionnaire for people who have gallbladder or bile duct cancer. The aim is to see if this questionnaire is more helpful than a general quality of life questionnaire. This trial has now closed and we are waiting for the results.

 

Finding a trial

If you are interested in taking part in a clinical trial, you need to ask your specialist if there are any current studies that may be suitable for you. Unfortunately, there are not many trials for gallbladder cancer (or biliary tract cancer) treatment in the UK as it is not a common cancer in this country. 

It can take longer to recruit enough patients for research studies than with a more common cancer. And the studies are likely to be smaller, which means there must be a more marked difference between treatments in order for it to show up. So, much of the research into gallbladder cancer takes place in countries where this type of cancer is more common.

You can find information about UK trials for gallbladder cancer (biliary tree) on our clinical trials database. 

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Updated: 24 June 2014