New findings from a recent clinical trial conducted by study leader Do-Youn Oh, M.D., Ph.D., a professor in the Division of Medical Oncology at Seoul National University Hospital in South Korea, provides further evidence that immunotherapy treatment for cancer patients can offer some hope.
Immunotherapy drugs are sometimes taken in conjunction with chemotherapy and radiation for cancer treatment. Immunotherapy is not as accessible as chemotherapy, due to its high cost, and the fact that compassionate supply requires meeting a certain criteria. Furthermore, many factors are considered to determine if a cancer patient qualifies for immunotherapy drugs.
Currently, if the cancer patient qualifies for immunotherapy treatment, they’ll have to pay the high cost of the drugs if they aren’t approved for compassionate supply. Many cancer patients and their families decide the cost of immunotherapy is worthwhile, and their oncologist can help them determine whether it’s worthwhile.
What Exactly is Immunotherapy?
If you’re unfamiliar with immunotherapy, it’s best explained by the Cancer Research Institute. According to the Cancer Research Institute,
“Cancer immunotherapy, also known as immuno-oncology, is a form of cancer treatment that uses the power of the body’s own immune system to prevent, control, and eliminate cancer.
Immunotherapy can:
- Educate the immune system to recognize and attack specific cancer cells
- Boost immune cells to help them eliminate cancer
- Provide the body with additional components to enhance the immune response.”
A promising form of immunotherapy is immunotherapy with immune checkpoint inhibitors. According to the National Cancer Institute, “Immunotherapy drugs called immune checkpoint inhibitors work by blocking checkpoint proteins from binding with their partner proteins. This prevents the ‘off’ signal from being sent, allowing the T cells to kill cancer cells.”
Immunotherapy is sometimes offered to advanced cancer patients with inoperable tumors, and various cancer patients who have the types of cancer that respond to immunotherapy.
Promising 2022 Clinical Trial Results from TOPAZ-1
Do-Young Oh, M.D., PhD., very recently led a study called TOPAZ-1, which was a clinical trial of 685 people with inoperable advanced biliary tract cancer, including advanced gallbladder cancer. The study found that the immunotherapy drug durvalumab, when used in addition to chemotherapy, modestly extended the life of people with advanced biliary tract cancer.
Durvalumab is an immunotherapy drug with an immune checkpoint inhibitor. The TOPAZ-1 trial was funded by AstraZeneca, the manufacturer of durvalumab.
Dr. Do-Young Oh presented the findings of her double-blind study at the American Society of Clinical Oncology Gastrointestinal Cancers Symposium in January of 2022.
As confirmed by the National Cancer Institute, “Biliary tract cancer, which includes cancer of the bile ducts and gallbladder, is rare, with an estimated 11,980 new cases diagnosed in the United States in 2021.”
According to the article entitled Durvalumab Modestly Improves Survival in Advanced Biliary Tract Cancer published by the National Cancer Institute (NCI), even a small or modest improvement in survival is noteworthy, because the prognosis for people with this rare and fast-growing type of cancer is quite poor, biliary tract cancer is difficult to treat, and treatment options are limited. NCI staff stated that at 2 years after starting treatment on the TOPAZ-1 trial, “roughly 25% of patients who received chemotherapy plus durvalumab were still alive, compared with 10% of patients who received chemotherapy plus a placebo.”
Those with biliary tract cancer typically have a poor prognosis, and immunotherapy can offer them some hope for a modest improvement in their prognosis. In the TOPAZ-1 trial, the study found that adding the immunotherapy drug durvalumab to standard chemotherapy extended the lives of the cancer patients by a median of approximately 6 weeks compared to patients who received standard chemotherapy plus a placebo.
This may not seem like much time, but the fact that immunotherapy treatment was able to improve the prognosis of patients with this incurable cancer at all is noteworthy. If an experimental drug works, that’s a positive outcome, and this study should offer those on immunotherapy some hope.
In an interview with the American Society of Clinical Oncology, Dr. Oh pointed out, “TOPAZ-1 is the first phase III trial to show that adding immunotherapy to standard chemotherapy can increase survival in biliary tract cancer, and importantly, does so without inducing any new serious side effects.”
The absence of serious side effects is another factor to be hopeful about, for cancer patients who are looking into their eligibility for immunotherapy treatment.
Why is Biliary Tract Cancer So Difficult to Treat?
Many types of biliary tract cancer don’t show any symptoms until the cancer is already at an advanced stage. At this point, often the cancer is inoperable and incurable.
For example, cancer of the gallbladder, a form of biliary tract cancer which is very rare, does not typically show any noticeable symptoms until it’s at an advanced stage with little hope for a cure.
Easy-to-ignore symptoms such as an oddly bright yellow color of urine, or a hint of yellow in the eyes, often go unnoticed or unaddressed. Nonspecificity of symptoms is unfortunate, because noticing these subtle yet early symptoms could change everything.
A hint of yellow in the eyes, caused by jaundice (a common symptom of biliary tract cancers such as gallbladder cancer or bile duct cancer) will eventually advance into yellowing of the skin. It’s at this point that symptoms tend to finally be noticed either by the cancer patient themself, or by their loved ones. This is because yellow skin is a much more noticeable sign of jaundice compared to a slight yellow hue of the eyes. At this point, you have to act fast for any hope that the cancer hasn’t already spread too much to be operable.
If the cancer has spread but it is operable, the patient may be looking at a 10 – 12 hour surgery, often including a Whipple procedure. However, a successful surgery doesn’t necessarily mean they’re in the clear. There is a high likelihood of recurrence, and at this point, prognosis is typically very poor. However, Dr. Oh’s findings in the double-blind TOPAZ 1 study indicate that a modest improvement in prognosis is possible with immunotherapy drugs in combination with other cancer treatments such as chemotherapy and radiation.
Biliary tract cancer is of course not the only type of advanced cancer that immunotherapy drugs can help treat. However, Dr. Oh’s double-blind study is one of the more recent trials conducted with immunotherapy drugs.
Prevention is Always Better Than Hope For a Cure
When it comes to cancer, prevention is always better than hoping for a cure. Not all types of cancers are curable, and immunotherapy likely won’t save the patient’s life, but rather give them a bit more time.
Certain healthy lifestyle habits can help prevent cancer, but what else can you do to prevent yourself from getting cancer?
For starters, you could take a DNA test to find out if you have any cancer-causing genetic mutations that increase your risk of developing certain cancers.
Note that if you do have one of these cancer-causing gene mutations, it doesn’t necessarily mean you’ll get cancer. Although certain genetic mutations can cause cancer, they don’t always cause cancer, and a lot of that has to do with preventative measures and lifestyle habits.
A DNA test from CircleDNA will help you figure out if you have a higher risk of any types of cancer, because of your genetic makeup.
Knowledge is power, so knowing about these gene mutations can help you make informed choices, stay vigilant, take preventative measures, and you’ll be less likely to ignore cancer symptoms. Noticing symptoms of cancer even one month earlier could save your life. Sometimes, you need to understand your genetic risk factors in order to become a more vigilant person. Furthermore, being armed with the knowledge of genetic risk factors helps motivate you to maintain healthy, cancer-preventing lifestyle habits.
References
- Durvalumab Significantly Improves Survival for Patients With Biliary Tract Cancer Compared to Chemotherapy Alone (American Society of Clinical Oncology, Inc.) https://www.asco.org/about-asco/press-center/news-releases/durvalumab-significantly-improves-survival-patients-biliary
- Durvalumab Modestly Improves Survival in Advanced Biliary Tract Cancer (National Cancer Institute at the National Institutes of Health) https://www.cancer.gov/news-events/cancer-currents-blog/2022/biliary-tract-cancer-durvalumab-improves-survival
- A phase 3 randomized, double-blind, placebo-controlled study of durvalumab in combination with gemcitabine plus cisplatin (GemCis) in patients (pts) with advanced biliary tract cancer (BTC): TOPAZ-1. (American Society of Clinical Oncology, Inc.) https://meetings.asco.org/abstracts-presentations/204876
- Immune Checkpoint Inhibitors (National Cancer Institute at the National Institutes of Health) https://www.cancer.gov/about-cancer/treatment/types/immunotherapy/checkpoint-inhibitors#:~:text=Immunotherapy%20drugs%20called%20immune%20checkpoint,checkpoint%20protein%20called%20CTLA%2D4.
- What Is Cancer Immunotherapy? (Cancer Research Institute) https://www.cancerresearch.org/en-us/immunotherapy/what-is-immunotherapy
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