The Drug Combo Imfinzi and Imjudo Helps Treat Advanced Liver Cancer
- FDA has approved the Imfinzi and Imjudo medication combination for advanced liver cancer treatment.
- The medicines boost your body’s defense system, aiming at specific targets to battle cancer effectively.
- The treatment is showing real benefits for patients with inoperable liver cancer, extending life and slowing the growth of the cancer.
- Treatment follows the STRIDE regimen which involves a special schedule of doses that aims for better survival rates and more manageable side effects.
The two drugs work together to fight cancer in patients with unresectable HCC,a type of liver cancer that can’t be removed with surgery because it is too advanced or complex in nature.
Read MoreHow Does Imfinzi-Imjudo Work?
Imfinzi and Imjudo team up to powerfully enhance your body’s immune system capabilities against cancer. Each uses a different yet complementary mechanisms.Imfinzi is a PD-L1 inhibitor.
PD-L1 is a protein on cancer cells that turns off T cells, a crucial type of immune cell, helping cancer hide from the immune system.
Imfinzi, is a checkpoint inhibitor, a drug designed to block the protein, stops PD-L1 from doing this. Essentially it “releases the brakes” on the immune system to attack cancer.
Imjudo targets CTLA-4
CTLA-4 is another form of a checkpoint protein on T cells, but it operates earlier in the immune response process compared to PD-L1 inhibitors. Its job is to act as a gatekeeper to prevent an overactive immune response.
By blocking CTLA-4, Imjudo amplifies the initial activation of T cells, improving the body’s immune response against cancer cells.
Imfinzi and Imjudo together
Together, the combination of Imfinzi and Imjudo targets two key ways cancer avoids the immune system.
This dual blockade not only boosts the activation and proliferation of T cells, it also reduces the ability of cancer cells to hide so tumors shrink more effectively and cancer progression is delayed for longer.
By accurately targeting specific immune pathways, this one-two punch effectively fights cancer while carefully controlling side effects.
“So we basically have two combination therapies that include components of immune therapy that are now considered are first line agents, and they have shown a significant survival benefit where people are living closer to the two year mark.” Dr. Jaffe says, “And even a subset of patients, like not an insignificant portion, are actually even kind of entering complete remission, which is really unheard of.”
Who is a good candidate for treatment with Imfinzi-Imjudo?
For patients with advanced liver cancer, the combination of Imfinzi and Imjudo may be a good option.
“We’re starting to see a benefit even in potentially patients that have advanced disease to begin with, so if you introduce medications even earlier, you can prevent recurrence. So they’re sort of entering this new era where we’re using them almost like prophylactically, as opposed to only treating a very select group of patients,” Dr. Jaffe says.
Some factors that make someone an ideal candidate for this treatment:
- Advanced liver cancer that cannot be treated with surgery or other treatments
- Earlier treatment such as chemotherapy or targeted therapy hasn’t worked
- Relatively good health to tolerate the potential side effects
- Working immune system
- No autoimmune diseases like Lupus or Rheumatoid Arthritis
- Good organ function
- Testing finds specific biomarkers like PD-L1 proteins that help predict a good response to the treatment
Your doctor will run a series of tests and evaluations to see if the therapy may be a good choice for you.
What is the treatment process like?
The National Comprehensive Cancer Network (NCCN), a not-for-profit alliance of leading cancer centers, recently updated its treatment guidelines to recommend Imfinzi with chemotherapy as a top choice for new patients.
Further, the NCCN guidelines recommends the combination of Imfinzi plus Imjudo as a preferred first-line systemic treatment option for unresectable HCC. This means that it is a recommended as a potential first treatment to try for patients with advanced liver cancer.
Doctors call the approach to this combination therapy the STRIDE regimen (Single Tremelimumab Regular Interval Durvalumab).
It involves:
- A single dose of Imjudo plus Imfinzi given with an IV drip
- Additional doses of Imfinzi every four weeks
- The duration of the STRIDE regimen depends on response, progression of the cancer, and side effects
Your doctor will closely watch you for response and possible side effects. Depending on your response, your doctor may recommend adjusting your treatment schedule.
Some patients respond really well to treatment, experiencing a halt or reversal in cancer progression. They can also tolerate the side effects associated with immunotherapy.
“We may convert patients from having extensive disease to potentially curable disease,” Dr. Jaffe says. “So that’s been a really exciting a really exciting aspect in the field.”
WATCH: Milan M. Kinkhabwala discusses Iiver cancer symptoms and screening
How effective is the treatment?
The FDA approval for Imfinzi in combination with Imjudo for treating unresectable hepatocellular carcinoma (HCC). which is a liver of the cancer cells that cannot be operated on, was based on the HIMALAYA Phase III trial.
Here are the key points:
- 22% lower risk of death in patients treated with the combo compared to the usual treatment
- 31% of patients on the combo therapy were still alive at least three years, compared to 20% given the standard therapy
- The median overall survival for patients on the combination was approximately 17 months. More than 30% survived at least 36 months.
- The treatment was safe, with no increased risk of severe liver toxicity or bleeding – this is especially important for patients with advanced liver disease
Some patients can build up a tolerance to the two medications which can limit the benefits of the treatment.
What are the possible side effects?
“Overall that the best part of everything is that these medications are really well tolerated. So the side effect profile is much less than that of our first line agents before,” Jaffe notes.
While Imfinzi in combination with Imjudo can be effective, many patients do experience side effects including:
- Rash
- Diarrhea
- Fatigue
- Itchiness
- Muscle or bone pain
- Stomach pain
Though rare, more serious side effects include:
- An overactive immune system
- Allergic reactions
- Kidney problems
- Nerve damage
Promptly report any unusual symptoms to your doctor.
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What is the cost for this treatment?
The annual cost of the Imfinzi-Imjudo drug regimen can add up to tens of thousands of dollars a year. However, most patients with insurance should be covered for treatment and could pay as little as $0 per infusion.
There are also prescription savings program available through AstraZeneca the makers of the drug. Patients who qualify will receive the drug at no cost.
Additionally, there are various independent foundations that help cover the cost of treatment, including co-pays, transportation, insurance premiums, and patient education support.
You should explore all payment and cost-saving options with your care team. They can help guide you on getting the treatment you need at a price you can afford.
Questions for your doctor
- Am I a good candidate for Imfinzi and Imjudo treatment?
- What benefits can I expect?
- What side effects can I expect?
- How long will my treatment take and how will you measure how well I am doing?
- What will my treatment cost?
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