PD-1 inhibitor combined with chemotherapy or lenvatinib in advanced gallbladder cancer: a retrospective comparative study.

Abstract

Background: Gallbladder cancer (GBC) is a refractory primary cancer. Some GBC patients are prone to recurrence even after surgical resection. In such cases, chemotherapy is the most common non-surgical treatment. The emergence of programmed cell death protein 1 (PD-1) inhibitors and targeted therapy have provided an additional option for those suffering from advanced tumors.

Methods: This was a retrospective study involving patients with advanced GBC treated at the Shanghai Eastern Hepatobiliary Surgery Hospital between June 2019 and June 2022. The patients who received a PD-1 inhibitor (tislelizumab) with chemotherapy or with lenvatinib were retrospectively analyzed. The Response Evaluation Criteria in Solid Tumors (RECIST 1.1) was used as the efficacy evaluation standard. The overall survival (OS), progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), and tumor marker CA199 were evaluated.

Results: This study involved 61 patients with advanced GBC. Of these, 32 patients received tislelizumab and GS (gemcitabine and TS-1) chemotherapy, whereas 29 patients received tislelizumab and lenvatinib. For the Tislelizumab plus GS chemotherapy group, the median OS and PFS were 19.64 ± 11.81 (95% CI: 16.47-25.20) and 15.44 ± 13.42 (95% CI: 12.08-22.25) months, respectively. For the lenvatinib group, the OS and PFS were 13.06 ± 9.41 (95% CI: 9.72-16.63) and 10.34 ± 10.03 (95% CI: 6.56-14.13) months, respectively. The ORR and DCR were 59.38% and 81.3%, respectively, for the Tislelizumab plus GS chemotherapy group, which were significantly longer than those for the Tislelizumab plus Lenvatinib group. Treatment-related adverse events were similar between the groups.

Conclusion: Tislelizumab combined with GS chemotherapy provides a safe and more efficient treatment option for advanced GBC patients.