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In Unresectable Gall Bladder Cancer, Chemotherapy Benefits

Gemcitabine/oxaliplatin appears to increase survival compared with best supportive care

THURSDAY, Sept. 23 (HealthDay News) -- Chemotherapy, particularly modified gemcitabine and oxaliplatin (mGEMOX), appears to be superior to best supportive care (BSC) in the treatment of patients with unresectable gall bladder cancer, according to research published online Sept. 20 in the Journal of Clinical Oncology.

Atul Sharma, M.D., of the All India Institute of Medical Sciences in New Delhi, and colleagues randomly assigned 81 patients to BSC (Group A), fluorouracil (FU) and folinic acid (FA) (Group B), or mGEMOX (Group C), to determine the efficacy of the latter against the first two treatments in patients with unresectable gall bladder cancer.

The researchers found that groups A, B, and C showed complete response plus partial response in 0, 14.3, and 30.8 percent of patients, respectively. One patient in group C experienced complete pathologic response. Median overall survival was 4.5, 4.6, and 9.5 months for groups A, B, and C, respectively, and progression-free survival was 2.8, 3.5, and 8.5 months in the three groups. Two patients in Group C and one in Group B had curative resection after chemotherapy.

"In summary, we have shown that palliative chemotherapy is superior to BSC, and that GEMOX may be a better choice for response rates, overall survival, and progression-free survival. Achievement of pathologic complete response is an encouraging finding, and identification of a molecular predictor for response and utility of positron emission tomography scan to assess active tumors should be addressed in future studies," the authors write.

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