Global gene expression landscape of gallbladder cancer and advances in targeted therapeutic strategies

Abstract

Gallbladder cancer (GBC) is a lethal biliary tract malignancy, which is infrequent in most developed countries, but common in many developing countries in specific geographical regions of the world. Non-specific symptoms leading to late diagnosis is one of the primary factors contributing to poor prognosis in GBC. An understanding of the complex relationship between molecular genetics and epidemiological variances in the incidence rates of GBC is thus of utmost importance. Present review summarizes recent updates on population-specific dysregulated genetic expressions in the genesis of GBC, highlighting the pattern of ethno-geographic variations and on advances in targeted therapies conducted till date; points out the lacunae that deserve further attention and suggest possible new directions for future clinical trials in GBC. The review calls for the need of genetic screening of each GBC patients and for more extensive clinical trials on targeted therapies to move towards the goal of personalized medicine, bringing about more favourable survival outcomes.

Keywords: Gallbladder cancer; Differential gene expression; Ethnic variations; Tumor biomarker; Targeted therapy; Personalized medicine

Core Tip: Gallbladder cancer (GBC) is a lethal biliary tract malignancy, with it’s incidence concentrated in specific geographic regions of the world, including India. Wide ethno-geographic disparity in GBC incidence rate is associated with unique population-specific genetic and molecular alterations. Present review specifically looks into the disparities in differential gene expression in the genesis of GBC across populations, summarizes the advances in targeted therapies in the treatment of GBC, highlights the need of developing population-specific biomarkers and provides possible directions for potential future clinical trials to improve the therapeutic outcomes of GBC.