The Role of Gemcitabine in the Treatment of Cholangiocarcinoma and Gallbladder Cancer: A Systematic Review
Bibliographic record
Abstract
BACKGROUND: Cholangiocarcinoma and gallbladder cancer are difficult to treat curatively. The treatment of choice is surgery, dependent on detection at a resectable stage. No chemotherapy or radiotherapy options have shown substantial activity. Gemcitabine has demonstrated response in similar cancers. Considering the lack of treatment options for cholangiocarcinoma and gallbladder cancer, a systematic review of the evidence on gemcitabine use for these indications was performed. OBJECTIVE: To perform a systematic review to evaluate the role of gemcitabine in the treatment of cholangiocarcinoma and gallbladder cancer. METHODS: The MEDLINE database was searched (1996 to March 2005) using the medical subject headings 'gemcitabine' and 'gallbladder neoplasms' with results limited to English only. Proceedings from the 1998 to 2004 meetings of the American Society of Clinical Oncology, including the 2004 Gastrointestinal Cancers Symposium, were searched for relevant abstracts. The Canadian Medical Association infobase and the National Guidelines Clearinghouse were also searched for practice guideline reports. Reports were selected and reviewed by two reviewers, and the reference lists from those were searched for additional trials. RESULTS: A total of 13 single-arm phase II trial reports were obtained. CONCLUSIONS: In appropriate patients with gallbladder cancer or cholangiocarcinoma, surgery offers the best chance for survival and should remain the first treatment of choice. For patients not considered candidates for surgery, but willing and able to tolerate chemotherapy alone or in combination with a fluoropyrimidine (such as 5-fluorouracil or capecitabine), gemcitabine appears to be a reasonable alternative to best supportive care, although this conclusion has not been confirmed with a randomized controlled trial.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".