Biliary tract cancer: our experience with gemcitabine treatment.

Biliary tract cancers are uncommon tumors, with a poor prognosis because most patients present an invasive cancer at diagnosis that makes them inoperable. Chemotherapy is a palliative treatment, but single drugs or combination schedules have demonstrated a response rate of 14-18%, with a duration of response of 8.5 months. We report a single center experience with gemcitabine in the treatment of patients with advanced biliary tract cancers. We report on four cases of chemonaive patients with advanced biliary tract cancers treated with gemcitabine 1 g/m q days 1, 8 and 15. After three cycles of treatment we observed one partial response and three stable disease (according to WHO criteria), with an increase in performance status and a complete relief of pain in all patients. The median time to progression observed was 10.7 months. Although this experience is limited to a small number of patients, it shows that gemcitabine appears to be worthy of clinical research in this neoplastic pathology and makes the drug a particularly interesting agent for investigation in patients with biliary tract malignancies.