Gallbladder cancer develops when malignant cells proliferate in the mucosal layer of the gallbladder and expand outward. It is the most prevalent biliary tract cancer, accounting for 80%-95% of cases worldwide and ranking sixth in terms of gastrointestinal cancer. Global statistics indicated that women had more illnesses than males, with over a million new cases recorded in 2020. Notably, Asia accounted for the majority of cases and fatalities, whereas Europe and the United States had comparatively fewer cases.

Gallbladder cancer is challenging to diagnose due to delayed symptom onset, often detected incidentally post-gallbladder surgery. Treatment recommendations involve surgery, radiation, and systemic therapies, guided by stage and R0 resectability. Cisplatin, gemcitabine, and durvalumab are recommended for first-line treatment. Post-surgery, adjuvant chemotherapy, and radiation address micrometastatic disease.

Analyzing the global clinical trial landscape since 2016, Asia-Pacific (APAC) played a substantial role, contributing over 50% of gallbladder cancer trials, primarily led by Mainland China and South Korea. The US and Europe conducted more than 40% of trials, with the United States and the United Kingdom taking leadership positions. APAC showcased accelerated trial durations and rapid enrolment rates, outpacing the US and Europe. Over the last decade, the CAGR in APAC demonstrated consistent growth, the US experienced a decline, and Europe underwent moderate expansion.

Venture funding for gallbladder cancer drug research exhibited annual fluctuations over the past five years, with Nanjing Transthera Biosciences and Jinfang Pharma emerging as key beneficiaries among biotech and pharma companies. Pipeline drugs for gallbladder cancer indicate a promising direction for treatment. Small molecules stand out as the dominant molecule type in various development phases, underscoring their potential impact.

In conclusion, Gallbladder cancer’s intricate landscape presents both challenges and opportunities. The global prevalence, unique epidemiological patterns, and shifting clinical trial dynamics underscore the need for targeted research efforts. The development of pipeline drugs, notably small molecules, and innovative drug classes, showcases the potential to transform GBC management, eventually improving patient outcomes and addressing the global burden of this cancer.