The first two authors contributed equally to this work High mobility group box Bl (HMGBl)-receptor for advanced glycation endproducts (RAGE) axis has been previously known to be involved in carcinogenesis and development of multiple malignancies. Some studies have confirmed that Ethyl pyruvate (EP), a potent inhibitor of HMGBl, exerts the therapeutic effects on metastatic live tumor from gastric cancer. However, the effects and possible molecular mechanisms of EP on gallbladder cancer (GBC) need to be further explored. In the present study, human GBC cell lines (GBC-SD and SGC-996) were treated with different concentrations of EP. Then, the expression levels of HMGBl, RAGE and some transcription factors were identified by Real-time PCR and Western blot assays. Cell proliferative activities indicated by MTT assay, invasive potential by Transwell assay and cell apoptosis and cycle distribution were performed for functional analysis of GBC cell lines in vitro. As a result, EP decreased the expression of HMGBll, RAGE, PCNA and matrix metallopeptidase-9 (MMP-9), while it increased the expression of p53. Moreover, EP administration decreased GBC cell proliferation, inhibited the invasive potential, and induced apoptosis and cycle arrest in S phase in GBC cells. In conclusion, EP administration inhibits growth and invasion of gallbladder cancer cells possibly via down-regulation of the HMGBl-RAGE axis, suggesting that EP may playa critical role in the treatment of cancer in conjunction with other therapeutic agents.High mobility group BI (HMGBI) has been known for its intracellular function as the intranuclear non-histone DNA binding protein and is regarded as an essential position in DNA repair. HMGBI and its counter-receptor, receptor for advanced glycation endproducts (RAGE), represent suitable targets for investigation, integrating many aspects of modem biology, particularly that associated with cancer (1). Originally, amphoterin, the major production of HMGB1, is over-expressed and closely associated with tumor invasion and metastasis. In human dendritic cells, RAGE is required for the effect of HMGB1 on cell expansion and survival. HMGB1/ RAGE interaction results in downstream activation of MAPK and NF-KB, representing a profitable evolutionary mechanism (2). Over-expression of HMGBI/RAGE, especially with membranous pattern, is associated with malignant potential