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Inclusion criteria included locally advanced or metastatic gallbladder cancer deemed unresectable by multidisciplinary team (MDT) consensus; age 18\u201375\u2009years; ECOG performance status \u2264\u20092; and AG as first\u2010line chemotherapy. Treatment response was assessed using RECIST 1.1 criteria. Primary endpoints were overall response rate (ORR) and progression\u2010free survival (PFS); secondary endpoints included disease control rate (DCR), overall survival (OS), and adverse events incidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirty\u2010one patients were enrolled. The ORR was 48.4%, and DCR was 90.3%. The median PFS was 8.4\u2009months (95% CI, 5.0\u201311.8), and the median OS was 20.9\u2009months (95% CI, 16.8\u201324.9). Among the 11 patients with locally advanced disease, 7 patients (63.6%) successfully converted to a resectable state and underwent surgery. Grade 3\/4 treatment\u2010related adverse events occurred in 11 patients (35.5%), predominantly hematologic toxicities, and no treatment\u2010related deaths or treatment discontinuations due to adverse events were observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>First\u2010line AG chemotherapy demonstrated promising efficacy and manageable safety for patients with unresectable GBC, with a substantial portion achieving disease control and some converting to resectable status.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.72120","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T04:26:14Z","timestamp":1787804774000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and Safety of First\u2010Line Chemotherapy With Gemcitabine Plus Nab\u2010Paclitaxel in Unresectable Gallbladder Cancer"],"prefix":"10.1002","volume":"15","author":[{"given":"Yue","family":"Yang","sequence":"first","affiliation":[{"name":"Department of General Surgery Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine  Shanghai China"},{"name":"Shanghai Key Laboratory of Biliary Tract Disease Research, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine  Shanghai China"},{"name":"Biliary Disease Research Institute of Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziyou","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery Southwest Hospital, Third Military Medical University (Army Medical University)  Chongqing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yidi","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of General 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