Gallbladder carcinoma: Current advances in molecular pathogenesis, biomarker discovery and precision medicine

Gallbladder carcinoma (GBC), an aggressive cancer of the biliary tract, is often diagnosed late and has a poor prognosis with limited treatment options.Recent developments in molecular oncology have significantly enhanced our understanding of GBC pathogenesis, and reports suggest that genetic and epigenetic changes, chronic inflammation, and tumor microenvironment alterations all contribute to the progression of GBC.Genomic profiling has pinpointed important molecular targets along with emerging immune and protein markers that could support personalised medicine.New diagnostic methods, including liquid biopsy, circulating tumor DNA, circulating tumor cells, exosome-derived markers, along with artificial intelligence-supported imaging, show potential for early diagnosis, prognosis, and disease monitoring.Moreover, immune-checkpoint inhibitors and combination immunotherapies are expanding treatment options for patients with advanced GBC.Despite these improvements, tumor heterogeneity, drug resistance, and the absence of reliable, validated markers still hinder the application of precision oncology in clinical practice.This review summarizes recent breakthroughs in molecular understanding and the emerging biomarker landscape for GBC.Additionally, we emphasize the high disease burden in the Indo-Gangetic region and the need for non-invasive screening tools for the Indian population.Finally, we highlight the urgent necessity for extensive studies in Indian cohorts that combine multiomics, liquid biopsy techniques, and extensive clinical profiling.