Efficacy and Toxicity Profile of Carboplatin/Gemcitabine Chemotherapy in Locally Advanced or Metastatic Biliary Tract Cancer: A Single UK Centre Experience

Background/Objectives: Biliary tract cancers (BTCs) refer to an invasive group of malignancies consisting of gallbladder cancer, ampullary cancer, and cholangiocarcinoma (CCA). BTCs are often diagnosed at advanced stages, leading to poor prognoses. While cisplatin-based chemotherapy remains the standard first-line treatment, carboplatin/gemcitabine serves as an alternative, particularly for patients with contraindications to cisplatin. This retrospective study evaluates the real-world efficacy and safety of carboplatin/gemcitabine in patients with advanced BTC who were ineligible for cisplatin-based treatment at a single UK centre. Methods: Data from 66 patients treated between March 2018 and July 2023 were analysed for overall survival (OS), progression-free survival (PFS), and toxicities. Results: The median OS was 8.97 months (95% CI: 6.78–11.16), and the median PFS was 5.88 months (95% CI: 4.78–6.98). Tumour control rate was achieved in 70% of cases. Patients receiving fewer than four chemotherapy cycles or presenting with poor baseline markers exhibited significantly worse survival outcomes (p < 0.05). Haematological toxicities were common, including thrombocytopenia (63.7%), neutropenia (48.5%), and anaemia (50.0%). Conclusions: While carboplatin/gemcitabine is a viable treatment for advanced BTC, larger trials are necessary to confirm its efficacy.