Breakthrough! Immunotherapy combination significantly prolongs the survival of patients with bile duct cancer!

May 23, 2020 /
BiogroinBIOON /-- A randomized, multicenter combination of immunotherapy and targeted therapy has improved cancer control in some rare and fatal types of gastrointestinal cancer, known as bile duct cancer (BTCs)This is an invasive cancer, and the standard treatment of most patients has not changed significantly for more than a decadeThe study, led by Nilofer Azad, an associate professor of oncology at Johns Hopkins Kimmel Cancer Center, and Mark Yarchoan, an assistant professor of oncology
at the, led the study in collaboration with the National Cancer Institute and 23 American Cancer CentersThe study tested a new combination of immunotherapy therapy for BTC, a highly immune-resistant cancerstudy included 86 patients with advanced BTC, a cancer that occurs in the liver bile excretion pipelineParticipants were aged between 44 and 86, and 62% (48) were women who received one or two treatmentsPatients were randomly treated with anti-PD-1 antibody atezolizumab immunotherapy (single treatment group) or atezolizumab combined MEK inhibitor cobimetinib therapy (combined treatment group)Of the patients involved in the study, 77 completed at least one dose of the treatment (39 in the single treatment group and 38 in the combined treatment group)The non-progressive survival of the combined treatment group was almost twice as long as in the single-treatment group (111 days vs 57 days)The difference of no progression survival conformed to the main endpoint of the study and was statistically significantimage source: https://cn.bing.com
Cobimetinib blocks MEK, which is part of a signal path known to be overactive in BTCsAlthough drugs that block MEK are less effective when used alone with BTC, they can alter theenvironment oftumors and make them more conducive to immunotherapyPrevious studies have found that a combination of two drugs, cobimetinib and anti-PD-L1 immunotherapy, can work together to enhance efficacy"We wanted to see if the combination of these two drugs could improve anticancer outcomes," saidYarchoan"To determine whether combination therapy is effective, Yarchoan and his co-authors chose to compare the benefits of individual immunotherapy and combination therapy in a randomized studyThe side effects ofcombination medication are controllable, including nausea, vomiting, rashes, lower blood cells and lower platelet countsThere were no treatment-related deaths, but 12 patients (4 received a separate atezolizumab monoantigen treatment and eight received combined treatment) were discontinued due to various side effectsdisease control rates, the ability to preventgrowth and progression oftumors, were 14/31 (45.2%) in the combined treatment group and 11/34 (32.4%) in the single treatment groupTwo patients who received the combination therapy remained in the study more than 15 months after the study began"The low response rate in both treatment groups highlights the challenges of BTC immunotherapy," Yarchoan saidHowever, compared to atezolizumab, the combined use of cobimetinib and atezolizumab reached its main destination, significantly extending the progression-free survival periodThis combination is worth further clinical studies "
BTC accounts for about 3% of all gastrointestinal cancers The standard treatment for advanced patients is gisitabinand and cisplatin combined chemotherapy, but patients receiving standard treatment have a survival period of less than one year Some patients with BTC may have specific mutations, and precision treatments for these mutations may be beneficial, Yarchoan said For example, a small number of PATIENTs with BTC have mismatch repair defects (MMR-d) in their tumors, and researchers at Johns Hopkins Kimmel Cancer have previously found that anti-PD-1 immunotherapy with pembrolizumab can be effective in treating MMR-d tumors Mismatchrepair is characterized by many mutations in genes that fix DNA replication errors A large number of mutations have been shown to attract immune cells to respond to cancer and are biomarker
of anti-PD-1 immunotherapy responses However, most patients with BTC no "operational" mutations in the of the tumor, and there has been no significant change in treatment for BTC since 2010 (BioValleyBioon.com) References: New Therapy combination extends s in some patients with lethal cancers
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