PD-1 inhibitor combined with chemotherapy or Lenvatinib in advanced gallbladder cancer: A retrospective comparative study

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Background Gallbladder cancer (GBC) is a refractory primary cancer. Some patients are prone to recurrence even after surgical resection. Chemotherapy is the most common non-surgical treatment used in these patients. The emergence of PD-1(programmed cell death protein 1) inhibitors and targeted therapy have provided an additional option for many advanced tumors. Methods This was a retrospective study of patients with advanced GBC treated at the Eastern Hepatobiliary Surgery Hospital between June 2019 and June 2022. The patients receiving a PD-1 inhibitor(Tislelizumab) with chemotherapy or with Lenvatinib were retrospectively analyzed. RECIST1.1 (response evaluation criteria in solid tumors) was used as the efficacy evaluation standard. The overall survival(OS), progression-free survival(PFS), objective response rate(ORR), disease control rate(DCR), tumor marker CA199 were evaluated. Results 61 patients with advanced GBC were included in the study. Including 32 patients received Tislelizumab plus GS(Gemcitabine and TS-1) chemotherapy, 29 patients received Tislelizumab combined with lenvatinib. Tislelizumab plus GS group median overall survival(OS) and progression-free survival(PFS) were 19.64 ± 11.81 (95% CI: 16.47–25.20) and 15.44 ± 13.42 (95% CI: 12.08–22.25) months. Tislelizumab plus Lenvatinib group median overall survival and progression-free survival were 13.06 ± 9.41 (95% CI: 9.72–16.63) and 10.34 ± 10.03 (95% CI: 6.56–14.13) months. The objective response rate, disease control rate were 59.38%, 81.3% with a Tislelizumab plus GS group, signifcantly longer than plus Lenvatinib group. Treatmentrelated adverse events were similar between two group. Conclusion Tislelizumab plus GS chemotherapy provides a safe and more efficient treatment option for advanced GBC patients.