Immunotherapy for gallbladder cancer

When you might have immunotherapy

You might have immunotherapy for gallbladder cancer if your cancer has a gene change (mutation) or a certain protein that helps the cancer grow. You might have immunotherapy if you have locally advanced or advanced (metastatic) gallbladder cancer.

Immunotherapy can be given on its own or with other treatments, such as chemotherapy. You may have it as part of a clinical trial.

You need to be quite fit and well to have some of these drugs. Your doctor will tell you if this treatment may be an option for you.

Tests on your gallbladder cancer cells

Doctors are increasingly testing to check for changes in genes (mutations) or certain proteins that help the cancer grow. They may look for changes in the:

• KRAS gene

• FGFR2 gene

• BRAF V600E gene

• TP53 gene

• HER2 protein 

• IDH1 gene

• NTRK gene

• changes in other genes involved in DNA  repair

They usually test a sample of your gallbladder cancer tissue from when you were first diagnosed. Or from your operation if you had one.

The results of the tests may show whether a targeted drug or immunotherapy is suitable for you.

Types of immunotherapy drugs for gallbladder cancer

Immunotherapy treatments do not always fit easily into a certain type or group of treatments. This is because some drugs or treatments work in more than one way and belong to more than one group. So, you might hear the same drug or treatment called different things.

For example, a type of immunotherapy called checkpoint inhibitors are also described as a monoclonal antibody or targeted treatment.

Read more about the different types of immunotherapy

Pembrolizumab (Keytruda)

Pembrolizumab is a type of immunotherapy called a checkpoint inhibitor. It stimulates the body's immune system to fight cancer cells. 

It targets and blocks a protein called PD-1 on the surface of certain immune cells called T-cells. Blocking the PD-1 protein triggers the T-cells to find and kill cancer cells.

Pembrolizumab is used if your gallbladder cancer cells have high ​microsatellite instability (MSI)​ or ​mismatch repair (MMR) deficiency.

You might have pembrolizumab if your gallbladder cancer is unresectable (can't have surgery) or has spread to other parts of the body, and other treatments have not worked.

Find out more about pembrolizumab and the side effects

Durvalumab (Imfinzi)

Durvalumab is another checkpoint inhibitor. Durvalumab seeks out cancer cells by looking for the PD-L1 protein and attaching to it. The immune system then recognises the marked cells and kills them.

You might have durvalumab in combination with gemcitabine and cisplatin for gallbladder cancer.

Find out more about durvalumab and the side effects

Having immunotherapy treatment

You have this treatment into your bloodstream through a drip into your arm. A nurse puts a small tube (a cannula) into one of your veins and connects the drip to it.

Or you might have treatment through a long line: a central line, a PICC line or a portacath. These are long plastic tubes that give the drug into a large vein in your chest. The tube stays in place throughout the course of treatment.

Find out more about how you have treatment into a vein

Side effects

Everyone is different and the side effects vary from person to person. The side effects you have depend on:

• which drug you have

• whether you have it alone or with other drugs

• the amount of drug you have (the dose)

• your general health

Targeted cancer drugs and immunotherapy drugs can cause serious side effects. Your doctor or nurse will talk to you about this. Always tell them about any side effects you have and follow the advice they give you. Some of the common side effects include:

• tiredness (fatigue)

• inflammation in the organs in your body

• loss of appetite

• low levels of blood cells

• feeling or being sick

• skin changes such as red and sore skin or an itchy rash

• flu-like symptoms such as chills, fever, dizziness

• diarrhoea

A side effect may get better or worse during your course of treatment. Or more side effects may develop as the treatment goes on or even after treatment has finished. So it is important to let your doctor know of any new symptoms. For more information about the side effects of your treatment, go to the individual drug pages.

A to Z list of cancer drugs

Research into targeted and immunotherapy drugs for gallbladder cancer

Researchers are looking at new and different types of targeted and immunotherapy drugs for gallbladder cancer.

They are also looking into different combinations. This includes combining them with chemotherapy or other types of drugs. They want to find out if they improve how well they work.  

New treatments are tested in clinical trials, so ask your doctor if there are any trials suitable for you.

Find out more about research into gallbladder cancer