Health Rounds: Drug cocktail helps keep liver cancer at bay

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By Nancy Lapid

(Reuters) – Adding a monoclonal antibody cocktail to the standard treatment for inoperable liver cancer nearly doubled the amount of time patients lived without their disease getting worse, researchers reported in The Lancet.

Traditionally, the best option for such patients is a procedure called transarterial chemoembolization (TACE), which shrinks the cancer by delivering chemotherapy drugs directly to the tumor and blocking its blood supply.

But adding the combination of Astra Zeneca’s Imfinzi, or durvalumab, and Roche’s Avastin, or bevacizumab, to treatment with TACE improved median progression-free survival to 15 months, compared to eight months with placebo, in a randomized trial involving more than 600 patients.

Adding Imfinzi alone was not helpful, the researchers also found. The researchers did not study Avastin given alone.

After accounting for patients’ individual risk factors, the chances of disease progression or death during nearly 28 months of follow-up were 23% lower with the addition of the two drugs.

TACE alone has been the standard of care for more than 20 years, and rates of disease progression have remained high, the researchers noted. The new combination therapy “shows promise in establishing a new standard of care,” they concluded.

Infrequent bone treatments helpful at younger ages

Just two treatments with a bone-strengthening drug, administered five years apart, can have long term benefits for women in early menopause, researchers reported in The New England Journal of Medicine.

Zoledronate, sold by Novartis as Zometa, is usually given every 18 months, with treatment more often directed at patients at high risk for fractures, such as the elderly, those with previous fractures or those with low bone mineral density, the researchers noted.

But women ages 50 to 60 who received two infusions of zoledronate separated by five years had a significantly reduced risk of vertebral fracture and better maintenance of bone mineral density during the 10 years following the first treatment, compared to similar women who got one or no infusions, they found.

The 1,054 women in the new study had low bone mineral density scores but not full-blown osteoporosis.

New fractures occurred in 6.3% of those who got both injections of zoledronate and in 11.1% of those who got two placebo injections.

After accounting for individual risk factors, the chances were 30% lower for any fracture in women who received two zoledronate injections, and were 40% lower for a major fracture.

Women who received only the first of the two zoledronate treatments also experienced a benefit, although not as large, the researchers said.

Markers of bone turnover – a sign of bone health – remained stable only in women who got both zoledronate shots. In the others, bone health showed slow deterioration.

“The results show that prevention of vertebral fractures in early postmenopausal women is possible with very infrequent infusions of zoledronate,” the researchers concluded.

An editorial published with the study noted that infrequent doses of the generic version of the drug “will result in a low cumulative dose and minimize both the costs and the side effects of treatment.”

(This is an excerpt of the Health Rounds newsletter, where we present latest medical studies on Tuesdays and Thursdays.)

(Reporting by Nancy Lapid; editing by Will Dunham)