Revision as of 18:38, 25 December 2019

Page editor		Section editor
	Ari Seifter, MD University of Illinois at Chicago Chicago, IL		Neeta K. Venepalli, MD, MBA University of Illinois at Chicago Chicago, IL

21 regimens on this page 26 variants on this page

Note: there is some overlap, especially in the earlier literature, between treatment regimens for gallbladder cancer and those for pancreatic adenocarcinoma, periampullary adenocarcinoma, and cholangiocarcinoma; please see those pages for additional regimens.

Guidelines

ESMO

2016: Valle et al. Biliary cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up

NCCN

NCCN Guidelines - Hepatobiliary Cancers

Adjuvant therapy

Capecitabine monotherapy

back to top

Regimen

Study	Evidence	Comparator	Efficacy
Primrose et al. 2019 (BILCAP)	Phase III (E-esc)	Observation	Might have superior OS

*79 of 447 enrolled patients (17.7%) had primary gallbladder cancer

Preceding treatment

Surgical resection with macroscopically curative resection
Chemotherapy start date 8-16 weeks after surgery

Chemotherapy

Capecitabine (Xeloda) 1250 mg/m² PO twice per day on days 1 to 14

21-day cycle for 8 cycles

References

BILCAP: Primrose JN, Fox RP, Palmer DH, Malik HZ, Prasad R, Mirza D, Anthony A, Corrie P, Falk S, Finch-Jones M, Wasan H, Ross P, Wall L, Wadsley J, Evans JTR, Stocken D, Praseedom R, Ma YT, Davidson B, Neoptolemos JP, Iveson T, Raftery J, Zhu S, Cunningham D, Garden OJ, Stubbs C, Valle JW, Bridgewater J; BILCAP study group. Capecitabine compared with observation in resected biliary tract cancer (BILCAP): a randomised, controlled, multicentre, phase 3 study. Lancet Oncol. 2019 May;20(5):663-673. Epub 2019 Mar 25. Erratum in: Lancet Oncol. 2019 Apr 2. link to original article PubMed

Capecitabine & Gemcitabine

back to top

GemCap: Gemcitabine & Capecitabine

Regimen

Study	Evidence
Ben-Josef et al. 2015 (SWOG S0809)	Phase II

*25 of 79 enrolled patients (32%) had primary gallbladder cancer

Preceding treatment

Surgical resection

Chemotherapy

Capecitabine (Xeloda) 750 mg/m²/day PO twice per day on days 1 to 14
Gemcitabine (Gemzar) 1000 mg/m² IV once per day on days 1 & 8

21-day cycle for 4 cycles

Subsequent treatment

Capecitabine & RT

References

SWOG S0809: Ben-Josef E, Guthrie KA, El-Khoueiry AB, Corless CL, Zalupski MM, Lowy AM, Thomas CR Jr, Alberts SR, Dawson LA, Micetich KC, Thomas MB, Siegel AB, Blanke CD. SWOG S0809: A phase II intergroup trial of adjuvant capecitabine and gemcitabine followed by radiotherapy and concurrent capecitabine in extrahepatic cholangiocarcinoma and gallbladder carcinoma. J Clin Oncol. 2015 Aug 20;33(24):2617-22. Epub 2015 May 11. link to original article link to PMC article contains verified protocol PubMed

GemOx

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GemOx: Gemcitabine & Oxaliplatin

Regimen

Study	Evidence	Comparator	Efficacy
Edeline et al. 2019 (PRODIGE 12-ACCORD 18-UNICANCER GI)	Phase III (E-esc)	Observation	Did not meet primary endpoint of RFS

*38 of 194 enrolled patients (20%) had primary gallbladder cancer.

Preceding treatment

Surgical resection with macroscopically curative resection

Chemotherapy

Gemcitabine (Gemzar) 1000 mg/m² IV once on day 1
Oxaliplatin (Eloxatin) 85 mg/m² IV once on day 2

14-day cycle for 12 cycles

References

PRODIGE 12-ACCORD 18-UNICANCER GI: Edeline J, Benabdelghani M, Bertaut A, Watelet J, Hammel P, Joly JP, Boudjema K, Fartoux L, Bouhier-Leporrier K, Jouve JL, Faroux R, Guerin-Meyer V, Kurtz JE, Assénat E, Seitz JF, Baumgaertner I, Tougeron D, de la Fouchardière C, Lombard-Bohas C, Boucher E, Stanbury T, Louvet C, Malka D, Phelip JM. Gemcitabine and Oxaliplatin Chemotherapy or Surveillance in Resected Biliary Tract Cancer (PRODIGE 12-ACCORD 18-UNICANCER GI): A Randomized Phase III Study. J Clin Oncol. 2019 Mar 10;37(8):658-667. Epub 2019 Feb 1. link to original article PubMed

Metastatic or unresectable disease, all lines of therapy

Best supportive care

back to top

Regimen

Study	Evidence	Comparator	Comparative Efficacy
Sharma et al. 2010	Randomized (C)	1. FUFA	Did not meet primary endpoint of OS
Sharma et al. 2010	Randomized (C)	2. mGEMOX	Seems to have inferior OS

No active antineoplastic treatment.

References

Sharma A, Dwary AD, Mohanti BK, Deo SV, Pal S, Sreenivas V, Raina V, Shukla NK, Thulkar S, Garg P, Chaudhary SP. Best supportive care compared with chemotherapy for unresectable gall bladder cancer: a randomized controlled study. J Clin Oncol. 2010 Oct 20;28(30):4581-6. Epub 2010 Sep 20. link to original article contains protocol PubMed

Capecitabine monotherapy

back to top

Regimen

Study	Evidence
Patt et al. 2004	Retrospective

Chemotherapy

Capecitabine (Xeloda) 1000 mg/m² PO twice per day on days 1 to 14

21-day cycles

References

Retrospective: Patt YZ, Hassan MM, Aguayo A, Nooka AK, Lozano RD, Curley SA, Vauthey JN, Ellis LM, Schnirer II, Wolff RA, Charnsangavej C, Brown TD. Oral capecitabine for the treatment of hepatocellular carcinoma, cholangiocarcinoma, and gallbladder carcinoma. Cancer. 2004 Aug 1;101(3):578-86. link to original article PubMed

CapeOx

back to top

CapeOx: Capecitabine & Oxaliplatin
XELOX: XELoda (Capecitabine) & OXaliplatin

Regimen

Study	Evidence	Comparator	Comparative Efficacy
Kim et al. 2019 (SMC 2011-05-070)	Phase III (E-switch-ic)	GEMOX	Non-inferior PFS

Chemotherapy

Capecitabine (Xeloda) 1000 mg/m² PO twice per day on days 1 to 14
Oxaliplatin (Eloxatin) 130 mg/m² IV once on day 1

21-day cycle for 8 cycles

References

SMC 2011-05-070: Kim ST, Kang JH, Lee J, Lee HW, Oh SY, Jang JS, Lee MA, Sohn BS, Yoon SY, Choi HJ, Hong JH, Kim MJ, Kim S, Park YS, Park JO, Lim HY. Capecitabine plus oxaliplatin versus gemcitabine plus oxaliplatin as first-line therapy for advanced biliary tract cancers: a multicenter, open-label, randomized, phase III, noninferiority trial. Ann Oncol. 2019 May 1;30(5):788-795. link to original article contains protocol PubMed

GemOx

back to top

GemOx: Gemcitabine & Oxaliplatin
mGEMOX: modified GEMcitabine & OXaliplatin

Variant #1, 900/80 ("mGEMOX")

Study	Evidence	Comparator	Comparative Efficacy
Sharma et al. 2010	Randomized (E-esc)	1. Best supportive care	Seems to have superior OS
Sharma et al. 2010	Randomized (E-esc)	2. FUFA	Not reported

Chemotherapy

Gemcitabine (Gemzar) 900 mg/m² IV once per day on days 1 & 8
Oxaliplatin (Eloxatin) 80 mg/m² IV once per day on days 1 & 8

21-day cycle for up to 6 cycles

Variant #2, 1000/100, bi-weekly

Study	Evidence	Comparator	Comparative Efficacy
Lee et al. 2011 (SMC 2008-12-024)	Phase III (C)	E-GEMOX	Might have inferior PFS

Chemotherapy

Gemcitabine (Gemzar) 1000 mg/m² IV once on day 1
Oxaliplatin (Eloxatin) 100 mg/m² IV once on day 2

14-day cycles

Variant #3, 1000/100, 2 weeks out of 3

Study	Evidence	Comparator	Comparative Efficacy
Kim et al. 2019 (SMC 2011-05-070)	Phase III (C)	XELOX	Non-inferior PFS

Chemotherapy

Gemcitabine (Gemzar) 1000 mg/m² IV once per day on days 1 & 8
Oxaliplatin (Eloxatin) 100 mg/m² IV once on day 1

21-day cycle for 8 cycles

References

Sharma A, Dwary AD, Mohanti BK, Deo SV, Pal S, Sreenivas V, Raina V, Shukla NK, Thulkar S, Garg P, Chaudhary SP. Best supportive care compared with chemotherapy for unresectable gall bladder cancer: a randomized controlled study. J Clin Oncol. 2010 Oct 20;28(30):4581-6. Epub 2010 Sep 20. link to original article contains protocol PubMed
SMC 2008-12-024: Lee J, Park SH, Chang HM, Kim JS, Choi HJ, Lee MA, Jang JS, Jeung HC, Kang JH, Lee HW, Shin DB, Kang HJ, Sun JM, Park JO, Park YS, Kang WK, Lim HY. Gemcitabine and oxaliplatin with or without erlotinib in advanced biliary-tract cancer: a multicentre, open-label, randomised, phase 3 study. Lancet Oncol. 2012 Feb;13(2):181-8. Epub 2011 Dec 20. link to original article contains protocol PubMed
SMC 2011-05-070: Kim ST, Kang JH, Lee J, Lee HW, Oh SY, Jang JS, Lee MA, Sohn BS, Yoon SY, Choi HJ, Hong JH, Kim MJ, Kim S, Park YS, Park JO, Lim HY. Capecitabine plus oxaliplatin versus gemcitabine plus oxaliplatin as first-line therapy for advanced biliary tract cancers: a multicenter, open-label, randomized, phase III, noninferiority trial. Ann Oncol. 2019 May 1;30(5):788-795. link to original article contains protocol PubMed

@@ Line 14: / Line 14: @@
 <div style="background-color: #deebf6; border: 1px solid #808000; padding: 5px; {{border-radius|16px}}"><font size="4"><b>{{#ask: [[-Has subobject::{{FULLPAGENAME}}]] |?Variant |limit=10000|format=sum}} [[Tutorial#Variants|variants]] on this page</b></font></div>
 |}
-<big>Note: there is some overlap, especially in the earlier literature, between treatment regimens for gallbladder cancer and those for '''[[pancreatic cancer|pancreatic adenocarcinoma]]''', '''[[periampullary adenocarcinoma]]''', and '''[[cholangiocarcinoma]]; please see those pages for additional regimens.</big>
+<big>Note: there is some overlap, especially in the earlier literature, between treatment regimens for gallbladder cancer and those for '''[[pancreatic cancer|pancreatic adenocarcinoma]]''', '''[[periampullary adenocarcinoma]]''', and '''[[cholangiocarcinoma]]; please see those pages for additional regimens.'''</big>
 {{TOC limit|limit=3}}
 =Guidelines=
 ==[http://www.esmo.org/ ESMO]==
-* '''2016:''' Valle et al. [https://www.esmo.org/Guidelines/Gastrointestinal-Cancers/Biliary-Cancer Biliary cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up]
+*'''2016:''' Valle et al. [https://www.esmo.org/Guidelines/Gastrointestinal-Cancers/Biliary-Cancer Biliary cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up]
 ==[https://www.nccn.org/ NCCN]==
 *[https://www.nccn.org/professionals/physician_gls/pdf/hepatobiliary.pdf NCCN Guidelines - Hepatobiliary Cancers]
 =Adjuvant therapy=
+<br />
+==Capecitabine monotherapy {{#subobject:f4c3d9|Regimen=1}}==
+{| class="wikitable" style="float:right; margin-left: 5px;"
+|-
+|[[Cholangiocarcinoma#top|back to top]]
+|}
+===Regimen {{#subobject:3a3bdf|Variant=1}}===
+{| class="wikitable" style="width: 100%; text-align:center;"
+! style="width: 25%" |Study
+! style="width: 25%" |[[Levels of Evidence#Evidence|Evidence]]
+! style="width: 25%" |Comparator
+! style="width: 25%" |[[Levels of Evidence#Efficacy|Efficacy]]
+|-
+|[https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(18)30915-X/fulltext Primrose et al. 2019 (BILCAP)]
+| style="background-color:#1a9851" |Phase III (E-esc)
+|[[Cholangiocarcinoma#Observation|Observation]]
+| style="background-color:#d9ef8b" |Might have superior OS
+|}
+<nowiki>*</nowiki>79 of 447 enrolled patients (17.7%) had primary gallbladder cancer
+====Preceding treatment====
+*[[Surgery|Surgical resection]] with macroscopically curative resection
+*Chemotherapy start date 8-16 weeks after surgery
+====Chemotherapy====
+*[[Capecitabine (Xeloda)]] 1250 mg/m<sup>2</sup> PO twice per day on days 1 to 14
+'''21-day cycle for 8 cycles'''
+===References===
+#'''BILCAP:''' Primrose JN, Fox RP, Palmer DH, Malik HZ, Prasad R, Mirza D, Anthony A, Corrie P, Falk S, Finch-Jones M, Wasan H, Ross P, Wall L, Wadsley J, Evans JTR, Stocken D, Praseedom R, Ma YT, Davidson B, Neoptolemos JP, Iveson T, Raftery J, Zhu S, Cunningham D, Garden OJ, Stubbs C, Valle JW, Bridgewater J; BILCAP study group. Capecitabine compared with observation in resected biliary tract cancer (BILCAP): a randomised, controlled, multicentre, phase 3 study. Lancet Oncol. 2019 May;20(5):663-673. Epub 2019 Mar 25. Erratum in: Lancet Oncol. 2019 Apr 2. [https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(18)30915-X/fulltext link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/30922733 PubMed]
+<br />
 ==Capecitabine & Gemcitabine {{#subobject:17f9f2|Regimen=1}}==
 {| class="wikitable" style="float:right; margin-left: 5px;"
@@ Line 40: / Line 77: @@
 |-
 |}
+<nowiki>*</nowiki>25 of 79 enrolled patients (32%) had primary gallbladder cancer
 ====Preceding treatment====
 *[[Surgery#Surgical_resection|Surgical resection]]
 ====Chemotherapy====
 *[[Capecitabine (Xeloda)]] 750 mg/m<sup>2</sup>/day PO twice per day on days 1 to 14
 *[[Gemcitabine (Gemzar)]] 1000 mg/m<sup>2</sup> IV once per day on days 1 & 8
@@ Line 48: / Line 90: @@
 '''21-day cycle for 4 cycles'''
 ====Subsequent treatment====
 *Capecitabine & RT
 ===References===
-# '''SWOG S0809:''' Ben-Josef E, Guthrie KA, El-Khoueiry AB, Corless CL, Zalupski MM, Lowy AM, Thomas CR Jr, Alberts SR, Dawson LA, Micetich KC, Thomas MB, Siegel AB, Blanke CD. SWOG S0809: A phase II intergroup trial of adjuvant capecitabine and gemcitabine followed by radiotherapy and concurrent capecitabine in extrahepatic cholangiocarcinoma and gallbladder carcinoma. J Clin Oncol. 2015 Aug 20;33(24):2617-22. Epub 2015 May 11. [https://ascopubs.org/doi/full/10.1200/JCO.2014.60.2219 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4534524/ link to PMC article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/25964250 PubMed]
+#'''SWOG S0809:''' Ben-Josef E, Guthrie KA, El-Khoueiry AB, Corless CL, Zalupski MM, Lowy AM, Thomas CR Jr, Alberts SR, Dawson LA, Micetich KC, Thomas MB, Siegel AB, Blanke CD. SWOG S0809: A phase II intergroup trial of adjuvant capecitabine and gemcitabine followed by radiotherapy and concurrent capecitabine in extrahepatic cholangiocarcinoma and gallbladder carcinoma. J Clin Oncol. 2015 Aug 20;33(24):2617-22. Epub 2015 May 11. [https://ascopubs.org/doi/full/10.1200/JCO.2014.60.2219 link to original article] [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4534524/ link to PMC article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/25964250 PubMed]
+<br />
+==GemOx {{#subobject:f8c8d9|Regimen=1}}==
+{| class="wikitable" style="float:right; margin-left: 5px;"
+|-
+|[[Cholangiocarcinoma#top|back to top]]
+|}GemOx: '''<u>Gem</u>'''citabine & '''<u>Ox</u>'''aliplatin
+===Regimen {{#subobject:3ghg3f|Variant=1}}===
+{| class="wikitable" style="width: 100%; text-align:center;"
+! style="width: 25%" |Study
+! style="width: 25%" |[[Levels of Evidence#Evidence|Evidence]]
+! style="width: 25%" |Comparator
+! style="width: 25%" |[[Levels of Evidence#Efficacy|Efficacy]]
+|-
+|[https://ascopubs.org/doi/full/10.1200/JCO.18.00050 Edeline et al. 2019 (PRODIGE 12-ACCORD 18-UNICANCER GI)]
+| style="background-color:#1a9851" |Phase III (E-esc)
+|[[Cholangiocarcinoma#Observation|Observation]]
+| style="background-color:#ffffbf" |Did not meet primary endpoint of RFS
+|}
+<nowiki>*</nowiki>38 of 194 enrolled patients (20%) had primary gallbladder cancer.
+====Preceding treatment====
+*[[Surgery|Surgical resection]] with macroscopically curative resection
+====Chemotherapy====
+*[[Gemcitabine (Gemzar)]] 1000 mg/m<sup>2</sup> IV once on day 1
+*[[Oxaliplatin (Eloxatin)]] 85 mg/m<sup>2</sup> IV once on day 2
+'''14-day cycle for 12 cycles'''
+===References===
+#'''PRODIGE 12-ACCORD 18-UNICANCER GI:''' Edeline J, Benabdelghani M, Bertaut A, Watelet J, Hammel P, Joly JP, Boudjema K, Fartoux L, Bouhier-Leporrier K, Jouve JL, Faroux R, Guerin-Meyer V, Kurtz JE, Assénat E, Seitz JF, Baumgaertner I, Tougeron D, de la Fouchardière C, Lombard-Bohas C, Boucher E, Stanbury T, Louvet C, Malka D, Phelip JM. Gemcitabine and Oxaliplatin Chemotherapy or Surveillance in Resected Biliary Tract Cancer (PRODIGE 12-ACCORD 18-UNICANCER GI): A Randomized Phase III Study. J Clin Oncol. 2019 Mar 10;37(8):658-667. Epub 2019 Feb 1. [https://ascopubs.org/doi/full/10.1200/JCO.18.00050 link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/30707660 PubMed]
 =Metastatic or unresectable disease, all lines of therapy=
@@ Line 61: / Line 139: @@
 ===Regimen===
 {| class="wikitable" style="width: 100%; text-align:center;"
-!style="width: 25%"|Study
+! style="width: 25%" |Study
-!style="width: 25%"|[[Levels_of_Evidence#Evidence|Evidence]]
+! style="width: 25%" |[[Levels_of_Evidence#Evidence|Evidence]]
-!style="width: 25%"|Comparator
+! style="width: 25%" |Comparator
-!style="width: 25%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
+! style="width: 25%" |[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 |-
-|rowspan=2|[https://ascopubs.org/doi/full/10.1200/JCO.2010.29.3605 Sharma et al. 2010]
+| rowspan="2" |[https://ascopubs.org/doi/full/10.1200/JCO.2010.29.3605 Sharma et al. 2010]
-|rowspan=2 style="background-color:#1a9851" |Randomized (C)
+| rowspan="2" style="background-color:#1a9851" |Randomized (C)
 |1. FUFA
 | style="background-color:#ffffbf" |Did not meet primary endpoint of OS
@@ Line 77: / Line 155: @@
 ''No active antineoplastic treatment.''
 ===References===
-# Sharma A, Dwary AD, Mohanti BK, Deo SV, Pal S, Sreenivas V, Raina V, Shukla NK, Thulkar S, Garg P, Chaudhary SP. Best supportive care compared with chemotherapy for unresectable gall bladder cancer: a randomized controlled study. J Clin Oncol. 2010 Oct 20;28(30):4581-6. Epub 2010 Sep 20. [https://ascopubs.org/doi/full/10.1200/JCO.2010.29.3605 link to original article] '''contains protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/20855823 PubMed]
+#Sharma A, Dwary AD, Mohanti BK, Deo SV, Pal S, Sreenivas V, Raina V, Shukla NK, Thulkar S, Garg P, Chaudhary SP. Best supportive care compared with chemotherapy for unresectable gall bladder cancer: a randomized controlled study. J Clin Oncol. 2010 Oct 20;28(30):4581-6. Epub 2010 Sep 20. [https://ascopubs.org/doi/full/10.1200/JCO.2010.29.3605 link to original article] '''contains protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/20855823 PubMed]
 ==Capecitabine monotherapy {{#subobject:c7cfeb|Regimen=1}}==
@@ Line 94: / Line 173: @@
 |}
 ====Chemotherapy====
 *[[Capecitabine (Xeloda)]] 1000 mg/m<sup>2</sup> PO twice per day on days 1 to 14
@@ Line 99: / Line 179: @@
 ===References===
-# '''Retrospective:''' Patt YZ, Hassan MM, Aguayo A, Nooka AK, Lozano RD, Curley SA, Vauthey JN, Ellis LM, Schnirer II, Wolff RA, Charnsangavej C, Brown TD. Oral capecitabine for the treatment of hepatocellular carcinoma, cholangiocarcinoma, and gallbladder carcinoma. Cancer. 2004 Aug 1;101(3):578-86. [https://onlinelibrary.wiley.com/doi/10.1002/cncr.20368/full link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/15274071 PubMed]
+#'''Retrospective:''' Patt YZ, Hassan MM, Aguayo A, Nooka AK, Lozano RD, Curley SA, Vauthey JN, Ellis LM, Schnirer II, Wolff RA, Charnsangavej C, Brown TD. Oral capecitabine for the treatment of hepatocellular carcinoma, cholangiocarcinoma, and gallbladder carcinoma. Cancer. 2004 Aug 1;101(3):578-86. [https://onlinelibrary.wiley.com/doi/10.1002/cncr.20368/full link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/15274071 PubMed]
 ==CapeOx {{#subobject:cf9acc|Regimen=1}}==
@@ Line 110: / Line 191: @@
 ===Regimen {{#subobject:1ef938|Variant=1}}===
 {| class="wikitable" style="width: 100%; text-align:center;"
-!style="width: 25%"|Study
+! style="width: 25%" |Study
-!style="width: 25%"|[[Levels_of_Evidence#Evidence|Evidence]]
+! style="width: 25%" |[[Levels_of_Evidence#Evidence|Evidence]]
-!style="width: 25%"|Comparator
+! style="width: 25%" |Comparator
-!style="width: 25%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
+! style="width: 25%" |[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 |-
 |[https://academic.oup.com/annonc/article/30/5/788/5345557 Kim et al. 2019 (SMC 2011-05-070)]
@@ Line 122: / Line 203: @@
 |}
 ====Chemotherapy====
 *[[Capecitabine (Xeloda)]] 1000 mg/m<sup>2</sup> PO twice per day on days 1 to 14
 *[[Oxaliplatin (Eloxatin)]] 130 mg/m<sup>2</sup> IV once on day 1
@@ Line 128: / Line 210: @@
 ===References===
-# '''SMC 2011-05-070:''' Kim ST, Kang JH, Lee J, Lee HW, Oh SY, Jang JS, Lee MA, Sohn BS, Yoon SY, Choi HJ, Hong JH, Kim MJ, Kim S, Park YS, Park JO, Lim HY. Capecitabine plus oxaliplatin versus gemcitabine plus oxaliplatin as first-line therapy for advanced biliary tract cancers: a multicenter, open-label, randomized, phase III, noninferiority trial. Ann Oncol. 2019 May 1;30(5):788-795. [https://academic.oup.com/annonc/article/30/5/788/5345557 link to original article] '''contains protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/30785198 PubMed]
+#'''SMC 2011-05-070:''' Kim ST, Kang JH, Lee J, Lee HW, Oh SY, Jang JS, Lee MA, Sohn BS, Yoon SY, Choi HJ, Hong JH, Kim MJ, Kim S, Park YS, Park JO, Lim HY. Capecitabine plus oxaliplatin versus gemcitabine plus oxaliplatin as first-line therapy for advanced biliary tract cancers: a multicenter, open-label, randomized, phase III, noninferiority trial. Ann Oncol. 2019 May 1;30(5):788-795. [https://academic.oup.com/annonc/article/30/5/788/5345557 link to original article] '''contains protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/30785198 PubMed]
 ==GemOx {{#subobject:c7cmar|Regimen=1}}==
@@ Line 139: / Line 222: @@
 ===Variant #1, 900/80 ("mGEMOX") {{#subobject:b343ca|Variant=1}}===
 {| class="wikitable" style="width: 100%; text-align:center;"
-!style="width: 25%"|Study
+! style="width: 25%" |Study
-!style="width: 25%"|[[Levels_of_Evidence#Evidence|Evidence]]
+! style="width: 25%" |[[Levels_of_Evidence#Evidence|Evidence]]
-!style="width: 25%"|Comparator
+! style="width: 25%" |Comparator
-!style="width: 25%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
+! style="width: 25%" |[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 |-
-|rowspan=2|[https://ascopubs.org/doi/full/10.1200/JCO.2010.29.3605 Sharma et al. 2010]
+| rowspan="2" |[https://ascopubs.org/doi/full/10.1200/JCO.2010.29.3605 Sharma et al. 2010]
-|rowspan=2 style="background-color:#1a9851" |Randomized (E-esc)
+| rowspan="2" style="background-color:#1a9851" |Randomized (E-esc)
 |1. [[#Best_supportive_care|Best supportive care]]
 | style="background-color:#91cf60" |Seems to have superior OS
@@ Line 154: / Line 237: @@
 |}
 ====Chemotherapy====
 *[[Gemcitabine (Gemzar)]] 900 mg/m<sup>2</sup> IV once per day on days 1 & 8
 *[[Oxaliplatin (Eloxatin)]] 80 mg/m<sup>2</sup> IV once per day on days 1 & 8
@@ Line 161: / Line 245: @@
 ===Variant #2, 1000/100, bi-weekly {{#subobject:c652ca|Variant=1}}===
 {| class="wikitable" style="width: 100%; text-align:center;"
-!style="width: 25%"|Study
+! style="width: 25%" |Study
-!style="width: 25%"|[[Levels_of_Evidence#Evidence|Evidence]]
+! style="width: 25%" |[[Levels_of_Evidence#Evidence|Evidence]]
-!style="width: 25%"|Comparator
+! style="width: 25%" |Comparator
-!style="width: 25%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
+! style="width: 25%" |[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 |-
 |[https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(11)70301-1/fulltext Lee et al. 2011 (SMC 2008-12-024)]
@@ Line 173: / Line 257: @@
 |}
 ====Chemotherapy====
 *[[Gemcitabine (Gemzar)]] 1000 mg/m<sup>2</sup> IV once on day 1
 *[[Oxaliplatin (Eloxatin)]] 100 mg/m<sup>2</sup> IV once on day 2
@@ Line 180: / Line 265: @@
 ===Variant #3, 1000/100, 2 weeks out of 3 {{#subobject:a6c33cb|Variant=1}}===
 {| class="wikitable" style="width: 100%; text-align:center;"
-!style="width: 25%"|Study
+! style="width: 25%" |Study
-!style="width: 25%"|[[Levels_of_Evidence#Evidence|Evidence]]
+! style="width: 25%" |[[Levels_of_Evidence#Evidence|Evidence]]
-!style="width: 25%"|Comparator
+! style="width: 25%" |Comparator
-!style="width: 25%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
+! style="width: 25%" |[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 |-
 |[https://academic.oup.com/annonc/article/30/5/788/5345557 Kim et al. 2019 (SMC 2011-05-070)]
@@ Line 192: / Line 277: @@
 |}
 ====Chemotherapy====
 *[[Gemcitabine (Gemzar)]] 1000 mg/m<sup>2</sup> IV once per day on days 1 & 8
 *[[Oxaliplatin (Eloxatin)]] 100 mg/m<sup>2</sup> IV once on day 1
@@ Line 198: / Line 284: @@
 ===References===
-# Sharma A, Dwary AD, Mohanti BK, Deo SV, Pal S, Sreenivas V, Raina V, Shukla NK, Thulkar S, Garg P, Chaudhary SP. Best supportive care compared with chemotherapy for unresectable gall bladder cancer: a randomized controlled study. J Clin Oncol. 2010 Oct 20;28(30):4581-6. Epub 2010 Sep 20. [https://ascopubs.org/doi/full/10.1200/JCO.2010.29.3605 link to original article] '''contains protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/20855823 PubMed]
-# '''SMC 2008-12-024:''' Lee J, Park SH, Chang HM, Kim JS, Choi HJ, Lee MA, Jang JS, Jeung HC, Kang JH, Lee HW, Shin DB, Kang HJ, Sun JM, Park JO, Park YS, Kang WK, Lim HY. Gemcitabine and oxaliplatin with or without erlotinib in advanced biliary-tract cancer: a multicentre, open-label, randomised, phase 3 study. Lancet Oncol. 2012 Feb;13(2):181-8. Epub 2011 Dec 20. [https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(11)70301-1/fulltext link to original article] '''contains protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/22192731 PubMed]
+#Sharma A, Dwary AD, Mohanti BK, Deo SV, Pal S, Sreenivas V, Raina V, Shukla NK, Thulkar S, Garg P, Chaudhary SP. Best supportive care compared with chemotherapy for unresectable gall bladder cancer: a randomized controlled study. J Clin Oncol. 2010 Oct 20;28(30):4581-6. Epub 2010 Sep 20. [https://ascopubs.org/doi/full/10.1200/JCO.2010.29.3605 link to original article] '''contains protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/20855823 PubMed]
-# '''SMC 2011-05-070:''' Kim ST, Kang JH, Lee J, Lee HW, Oh SY, Jang JS, Lee MA, Sohn BS, Yoon SY, Choi HJ, Hong JH, Kim MJ, Kim S, Park YS, Park JO, Lim HY. Capecitabine plus oxaliplatin versus gemcitabine plus oxaliplatin as first-line therapy for advanced biliary tract cancers: a multicenter, open-label, randomized, phase III, noninferiority trial. Ann Oncol. 2019 May 1;30(5):788-795. [https://academic.oup.com/annonc/article/30/5/788/5345557 link to original article] '''contains protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/30785198 PubMed]
+#'''SMC 2008-12-024:''' Lee J, Park SH, Chang HM, Kim JS, Choi HJ, Lee MA, Jang JS, Jeung HC, Kang JH, Lee HW, Shin DB, Kang HJ, Sun JM, Park JO, Park YS, Kang WK, Lim HY. Gemcitabine and oxaliplatin with or without erlotinib in advanced biliary-tract cancer: a multicentre, open-label, randomised, phase 3 study. Lancet Oncol. 2012 Feb;13(2):181-8. Epub 2011 Dec 20. [https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(11)70301-1/fulltext link to original article] '''contains protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/22192731 PubMed]
+#'''SMC 2011-05-070:''' Kim ST, Kang JH, Lee J, Lee HW, Oh SY, Jang JS, Lee MA, Sohn BS, Yoon SY, Choi HJ, Hong JH, Kim MJ, Kim S, Park YS, Park JO, Lim HY. Capecitabine plus oxaliplatin versus gemcitabine plus oxaliplatin as first-line therapy for advanced biliary tract cancers: a multicenter, open-label, randomized, phase III, noninferiority trial. Ann Oncol. 2019 May 1;30(5):788-795. [https://academic.oup.com/annonc/article/30/5/788/5345557 link to original article] '''contains protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/30785198 PubMed]
 [[Category:Gallbladder cancer regimens]]
 [[Category:Disease-specific pages]]
 [[Category:Hepatobiliary cancers]]

Difference between revisions of "Gallbladder cancer"

Revision as of 18:38, 25 December 2019

Guidelines

ESMO

NCCN

Adjuvant therapy

Capecitabine monotherapy

Regimen

Preceding treatment

Chemotherapy

References

Capecitabine & Gemcitabine

Regimen

Preceding treatment

Chemotherapy

Subsequent treatment

References

GemOx

Regimen

Preceding treatment

Chemotherapy

References

Metastatic or unresectable disease, all lines of therapy

Best supportive care

Regimen

References

Capecitabine monotherapy

Regimen

Chemotherapy

References

CapeOx

Regimen

Chemotherapy

References

GemOx

Variant #1, 900/80 ("mGEMOX")

Chemotherapy

Variant #2, 1000/100, bi-weekly

Chemotherapy

Variant #3, 1000/100, 2 weeks out of 3

Chemotherapy

References

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