Are there antibody-drug conjugates approved for Gallbladder Cancer

Antibody-Drug Conjugates (ADCs) for Gallbladder Cancer

Based on current NCCN Guidelines for Biliary Tract Cancers (Version 2.2025), there is one key antibody-drug conjugate with emerging evidence for gallbladder cancer:

Trastuzumab Deruxtecan (T-DXd)

What it is: Trastuzumab deruxtecan is an antibody-drug conjugate that combines an antibody targeting HER2 with a chemotherapy payload. Think of it as a "guided missile" — the antibody finds and attaches to HER2 proteins on cancer cells, then delivers chemotherapy directly to those cells.

When it may be used: According to NCCN Guidelines, trastuzumab deruxtecan is recommended for patients with HER2-positive biliary tract cancers (including gallbladder cancer) that have progressed after initial treatment.

Important context: The approval and use of T-DXd for gallbladder cancer is relatively recent. The NCCN Guidelines reference clinical trial data (DESTINY-PanTumor02) showing efficacy in HER2-expressing solid tumors, including biliary cancers.

What You Need to Know

HER2 testing is essential: Before considering any HER2-targeted therapy, your tumor must be tested for HER2 status. According to NCCN Guidelines, HER2 testing should be performed on gallbladder cancer tissue using multiple testing methods (immunohistochemistry, in-situ hybridization, or next-generation sequencing).

Other HER2-targeted options mentioned in NCCN Guidelines include:

• Trastuzumab + pertuzumab (combination approach)
• Tucatinib + trastuzumab (another combination)

Questions to Ask Your Oncologist

1. Has my tumor been tested for HER2 status? If not, can this testing be done?
2. If my tumor is HER2-positive, is trastuzumab deruxtecan an option for my stage of disease?
3. What are the side effects I should expect, and how is this drug monitored?
4. Are there clinical trials available for HER2-targeted therapies in gallbladder cancer?
5. What other treatment options exist if my tumor is HER2-negative?

Additional Context

The NCCN Guidelines emphasize that molecular testing of your gallbladder cancer is important to identify actionable mutations and protein overexpression (like HER2). This testing helps your oncology team select the most targeted treatment approach for your specific cancer.

According to NCCN Guidelines for Biliary Tract Cancers, systemic therapy decisions should be made in consultation with your multidisciplinary team, considering your overall health, stage of disease, and specific tumor characteristics.

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This information is for educational purposes only. Always consult your healthcare team for personalized medical advice and decisions.