Just because we are staying home to avoid COVID-19 doesn’t mean the medical field has stopped! In fact, many doctors are more determined than ever to improve patient outcomes. In a study published in JAMA Oncology, researchers discuss the efficacy and tolerability of nivolumab-ipilimumab combination for the treatment of biliary tract cancer.
Biliary Tract Cancer
Also known as cholangiocarcinoma, biliary tract cancer is a rare form of cancer affecting the biliary tract. This involves tubes that bring bile from the liver to the small intestine. Bile duct inflammation, age, diabetes, and Thorotrast exposure are risk factors.
Generally, symptoms do not appear until the cancer progresses. These symptoms include, but are not limited to:
- Unintended weight loss
- Appetite loss
- Dark urine and pale feces
- Jaundice
- Intensely itchy skin
- Nausea and vomiting
- Fatigue
- Muscle weakness
- Fever
- Abdominal pain
Learn more about biliary tract cancer here.
Nivolumab-Ipilimumab Combination
For a long time, chemotherapy has been used as a first-line treatment for this form of cancer. However, notes Dr. Oliver Klein, this only mildly improves survival rates. In his recent study, Dr. Klein and his research team attempted to understand whether combination immunotherapy using nivolumab-ipilimumab could improve patient outcomes, survival rates, and tumor response.
First, researchers analyzed data from a Phase 2 clinical trial. Within this study were a variety of patients with advanced-stage rare cancers. Of these patients, 39 had biliary tract cancer. All 39 patients, whose average age was 65, tried at least one prior treatment. Additionally, tumor tissue was sourced from each patient.
During the study, patients received 4 doses of 3mg/kg nivolumab and 1mg/kg ipilimumab every 3 weeks. Next, patients received 3mg/kg nivolumab bi-weekly for up to 96 weeks (22 months). However, they only received this if they experienced no toxicity or disease progression.
Overall, eight patients (20%) left the study following rapid cancer progression. Nine patients responded in some way to nivolumab-ipilimumab, and 17 were able to control their cancer. All responses were noted in patients with either intrahepatic cholangiocarcinoma or gallbladder carcinoma biliary tract cancers. Generally, patients survived without disease progression for 2.9 months, and overall around 5.7 months. While nivolumab-ipilimumab was never fatal, it did result in serious adverse reactions in 15% of patients.
The results suggest that this therapy could provide some benefit to these patients.
Read the source article here.
