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Immunotherapy

What is Immunotherapy?

Immunotherapy is a treatment that activates or suppresses the immune system and by that assist the immune system in attacking the tumor. This type of treatment is very different from chemotherapy, for example, which directly attacks the cancerous cells but unfortunately also damages healthy tissues.

The immune system has “immune barriers” which serve to regulate the immune system and prevent it from attacking the body. In cancer these functions are readily activated and as a result, the immune system ceases to attack cancerous cells, enabling the tumor to grow and proliferate in the body.

Barriers known as PD-L1, PD-1 and CTLA-4 are found on T-cells and cancer cells. For example, the biological drug Opidivo® (generic name: Nivolumab) activates the immune system against the tumor.

Immunotherapy is a revolutionary strategy, and one of the most widely studied worldwide for its application to numerous types of cancer and various stages of the disease’s development. Treatment is generally provided in the form of an intravenous infusion.

Immunotherapy drugs examples:

PD-1 drugs:
• Keytruda® (Pembrolizumab)
• Opdivo® (Nivolumab)

PD-L1 drugs:
• Tecentriq® (Atezolizumab)
• Imfinzi® (Durvalumab)

What are the most common side effects?

Reaction of the skin

Redness, blisters and dryness. The skin can become sensitive when exposed to sunlight. Inflammation around the fingernails can occur and cause pain when dressing, for example.

Flu-like symptoms

Fatigue, fever, chills, nausea, vomiting, dizziness, body pain and high or low blood pressure

Other side effects may be:

  • Muscle Pain
  • Difficulties in breathing
  • Swelling of the legs
  • Sinus congestion
  • Headaches
  • Weight gain due to accumulation of fluids
  • Diarrhea
  • Hormonal changes
  • Cough

And there could be more

Most of the side effects will disappear at the end of the immunotherapy treatment, but some can occur months and even years later.

It is important to consult with your healthcare professional about coping with side effects.

TRIAL-IN-Pharma offers a unique, personalized research and analysis for patients with metastatic cancer and brain tumors, which reveals innovative and advanced oncologic treatments around the world and support the process of achieving them.

Read our publications on immunotherapy and other innovative treatments for stage 4 metastatic cancer:

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Colorectal Cancer – New 1st for Left-Sided RAS-WT

Overview

Colorectal cancer is one of the most common types of malignant tumors in humans. According to statistics, the risk of developing this tumor in a lifetime is:

  • Around 1 in 23 (4.3%) for men
  • Around 1 in 25 (4.0%) for women

Unfortunately, many cases of colorectal cancer are revealed when the cancerous cells have already spread beyond their original location. We call this metastatic cancer.

In this article, we will cover the findings of a phase III clinical study that inspected the effectiveness of Vectibix on left-sided RAS wild type (wt) metastatic colorectal cancer.

What is left-sided RAS wild-type (WT) metastatic colorectal cancer?

RAS is the most common genetic mutation found in patients with colon cancer. Therefore, adding the term ‘RAS’ before a cancer means this specific genetic mutation is present.

Wild-type (WT) RAS means there are no mutations present on the RAS genes.

Therefore, a left-sided RAS wild-type (WT) metastatic colon cancer translates to:

A colorectal cancer that originated in the left side of the colon and spreads beyond original location. No mutations in the RAS genes were identified.

What is Vectibix in colon cancer?

Vectibix is beneficial in treating colorectal cancers that express epidermal growth factor receptors (EGFRs) on the surface of the cells. The indication of using this drug for colorectal cancer is limited to metastatic cases.

The doctor may recommend this treatment for patients who failed to improve after receiving the following chemotherapeutic agents:

  • Fluoropyrimidine
  • Oxaliplatin
  • Irinotecan

How to give Vectibix?

Like many other biological drugs, healthcare professionals administer Vectibix via an intravenous infusion. To deliver this drug, doctors use an infusion pump.

The dosage of Vectibix for the treatment of metastatic colorectal cancer depends on several factors. These include your weight, height, concurrent medical conditions, and general health.

The findings from the PARADIGM study in colon cancer

This clinical trial is called the “PARADIGM trial”. This clinical trial was conducted in Japan, where researchers randomly recruited patients with RAS WT metastatic colorectal cancer. The number of patients mounted to 823 between May 2015 and June 2017. Out of these patients, 12 did not receive the treatment, and 9 were excluded from the study because they lacked some of the inclusion criteria. The vast majority of patients had left-sided colon cancer.

The primary endpoint for this study was Survival. Secondary endpoints included progression-free survival (PFS, the time for the disease to progress under the treatment), Response Rate (RR – percentage of patients whose tumors’ volume decreased by 30-50%), and curative resection (R0) rate.

After randomization, patients were divided into two groups:

  • The first group (400 patients – 312 of which had left-sided colon cancer) – Received Vectibix plus chemotherapy
  • The second group (402 patients – 292 of which had left-sided colon cancer) – received Avastin plus chemotherapy

After analyzing the results, Vectibix significantly improved Survival compared to Avastin, 37.9 months vs 34.3.

As for PFS, it was comparable between the two groups. Despite that, RR and R0 were much higher in the first group compared to the second one.

These results clearly demonstrate the superiority of Vectibix in treating left-sided RAS-WT metastatic colorectal cancer.

Takeaway message for colon cancer patients

Using Vectibix to treat left-sided RAS-WT metastatic colorectal cancer showed promising results in the PARADIGM clinical trial.

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