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Combining liver cancer treatments doubles survival rates, UVA researchers find
April 16, 2008By combining the use of stents and photodynamic therapy, also called SpyGlass, physicians at the University of Virginia have been able to significantly increase survival rates for patients suffering from advanced cholangiocarcinoma, cancer of the liver bile duct.
"Most patients who develop this type of cancer cannot have surgery as it is diagnosed at such a late stage, so there was not much we could do except offer them palliative care," said University of Virginia Gastroenterologist Michel Kahaleh, M.D., lead investigator of the study. "By combining therapies, we saw an improved survival rate from just more than 7 months to more than 16 months."
In the study, recently published in the March 2008 issue of Clinical Gastroenterology and Hepatology, 48 patients were treated with advanced cholangiocarcinoma over a five year period. Twenty-nine patients were treated with biliary stents, with the remaining 19 being treated with the stents and photodynamic therapy (PDT). The stents decompress the bile ducts, maintaining liver function. The combined therapy group received treatment every three months, at which time all stents were replaced.
The combined therapy group had survival rates of 16.2 months compared to the stent-only group's 7.4 months. Mortality rates in the group that received PDT was 0, 16, and 56 percent at three, six, and 12 months respectively. Mortality rates in the stent-only group were 28, 52, and 82 percent respectively. Kahaleh said the number of stent-replacement procedures and PDT sessions were the only factors which significantly impacted survival.
Photodynamic Therapy treatment uses a photosensitizing agent (porfimer sodium in this study) which is activated using light of a specific wavelength, which then kills the targeted cells. PDT has been used for more than a decade to destroy cancer cells and reduce tumor size.
Cancer of the liver bile ducts is the second most common liver cancer and has significant mortality and mortality. Of the approximately 2,000 cases diagnosed each year, the vast majority of patients survive up to three months without intervention or four to six months with decompression treatment.
"Stents alone do not destroy or shrink the tumors or cancer cells. We were not surprised that the combined therapy offers a significant benefit to the patient, as this is accepted treatment in Europe," said Kahaleh. "However the FDA (Food and Drug Administration) wants to see more data so we have completed what we believe is the first published comparative American study on the treatment."
Kahaleh hopes to begin a multi-center trial within six months.
University of Virginia Health System
The combined therapy group had survival rates of 16.2 months compared to the stent-only group's 7.4 months. Mortality rates in the group that received PDT was 0, 16, and 56 percent at three, six, and 12 months respectively. Mortality rates in the stent-only group were 28, 52, and 82 percent respectively. Kahaleh said the number of stent-replacement procedures and PDT sessions were the only factors which significantly impacted survival.
Photodynamic Therapy treatment uses a photosensitizing agent (porfimer sodium in this study) which is activated using light of a specific wavelength, which then kills the targeted cells. PDT has been used for more than a decade to destroy cancer cells and reduce tumor size.
Cancer of the liver bile ducts is the second most common liver cancer and has significant mortality and mortality. Of the approximately 2,000 cases diagnosed each year, the vast majority of patients survive up to three months without intervention or four to six months with decompression treatment.
"Stents alone do not destroy or shrink the tumors or cancer cells. We were not surprised that the combined therapy offers a significant benefit to the patient, as this is accepted treatment in Europe," said Kahaleh. "However the FDA (Food and Drug Administration) wants to see more data so we have completed what we believe is the first published comparative American study on the treatment."
Kahaleh hopes to begin a multi-center trial within six months.
University of Virginia Health System
Photodynamic Therapy Current Events and Photodynamic Therapy News RSSPhotodynamic therapy effective for certain head and neck cancers
A combination of medications and a particular light therapy is effective at treating certain types of head and neck cancers in subtropical climates.
Novel light-sensitive compounds show promise for cancer therapy
Chemists at the University of California, Santa Cruz, have developed novel compounds that show promise for photodynamic cancer therapy, which uses light-activated drugs to kill tumor cells.
NEJM study finds radiofrequency ablation can reverse Barrett's esophagus, reduce cancer risk
Patients who have gastroesophageal reflux disease (GERD) for a prolonged period have an increased risk of developing Barrett's esophagus, a pre-cancerous condition where the tissue lining the esophagus becomes damaged by stomach acid and transformed into something like the inside of the stomach.
Mayo Clinic finds new pathology tests double sensitivity to detect bile duct and pancreatic cancers
Pancreatic cancer and bile duct cancer are difficult to diagnose and often fatal because they are discovered in the advanced stages of the disease.
New radiation-free targeted therapy detects and eliminates breast cancer tumors in mice
Combining a compound known as a gallium corrole with a protein carrier results in a targeted cancer therapy that is able to detect and eliminate tumors in mice with seemingly fewer side effects than other breast-cancer treatments, says a team of researchers from the California Institute of Technology (Caltech), the Israel Institute of Technology (Technion) and the Cedars-Sinai Medical Center.
A sticky business -- how cancer cells become more 'gloopy' as they die
The viscosity, or 'gloopiness', of different parts of cancer cells increases dramatically when they are blasted with light-activated cancer drugs, according to new images that provide fundamental insights into how cancer cells die, published in Nature Chemistry today (15 March).
Conference report highlights new research into drug delivery to treat eye disease
Researchers are investigating microneedles, nanoparticles and polymer carriers as potential new techniques to combat the leading cause of visual impairment and blindness in the United States, according to a report from the Third Annual ARVO/Pfizer Ophthalmics Research Institute Conference.
Endoscopic therapy may offer an alternative to surgery
Endoscopic therapy is emerging as an alternative to surgery in patients with esophageal cancer given the low likelihood of spread to the lymph nodes.
Cancer drug delivery research at Case Western Reserve University cuts time from days to hours
Researchers at Case Western Reserve University have developed a technique that has the potential to deliver cancer-fighting drugs to diseased areas within hours, as opposed to the two days it currently takes for existing delivery systems.
Combined stenting and photodynamic therapy improves survival in late stage liver cancer patients
A combined therapeutic approach of stenting and photodynamic therapy may improve survival rates for patients suffering from advanced liver bile duct cancer, according to a study published this month in Clinical Gastroenterology and Hepatology, the official journal of the American Gastroenterological Association (AGA) Institute.
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Procedures in Cosmetic Dermatology Series: Photodynamic Therapy by Mitchel P. Goldman MD (Author) This title in the PROCEDURES IN COSMETIC DERMATOLOGY SERIES presents up-to-the-minute, practical guidance on the hottest photodynamic therapy techniques shaping today's practice. Succinctly written and lavishly illustrated, it focuses on procedural how-to's and offer step-by-step advice on proper techniques, pitfalls, and tricks of the trade-so you can refine and hone your skills...and expand your surgical repertoire. You'll find current, to-the-point guidance on the cosmetic use of PDT-edited by a pioneer in the field, Dr. Mitchel P. Goldman. Implement the newest procedures into your practice immediately and confidently-with the outstanding guidance you'll find in this volume of the PROCEDURES IN COSMETIC DERMATOLOGY SERIES. Get the best results when performing PDT for skin... |
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The Aging Eye: New Therapies for Age Related Macular Degeneration In the past two years, there have been rapid and dramatic improvements in the treatment of macular degeneration which is the leading cause of blindness in the United States in persons over age 65. In this lecture, Mark Blumenkranz, MD covers new advances in this disease that have changed our understanding and approach to it. Mark S. Blumenkranz, MD, is Professor and Chairman of the Department of Ophthalmology at Stanford University. He is the author of more than 100 peer-reviewed publications and book chapters in the area of vitreoretinal surgery, with special interests in surgical adjuvant pharmacology and new microsurgical and laser techniques. Dr. Blumenkranz was instrumental in developing the successful laser vision correction program at Stanford and serves as a principal... |
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Skin Eternal 240 Tabs (Formerly Skin Renew) by Source Naturals Skin Eternal contains five key ingredients that together protect the skin and support healthy skin tissue. Ascorbyl palmitate is a fat-soluble vitamin C ester, which may be more effective than water-soluble C in providing antioxidant protection to the lipids in cell membranes, according to in-vitro research. DMAE is an immediate precursor of choline, an important component of skin cell membranes. Alpha-lipoic acid is a powerful fat- and water-soluble antioxidant that recycles the antioxidant vitamins C and E. Grape seed extract scavenges lipid and water-soluble free radicals, and supports the integrity of elastin and collagen. |
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