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Drugs Deemed Safe, Effective for Biliary Tract Cancers

Gemciatbine, oxaliplatin and bevacizumab combination likely safe with anti-tumor activity


MONDAY, Nov. 23 (HealthDay News) -- Combination treatment with bevacizumab, gemcitabine, and oxaliplatin is safe and effective in treating advanced biliary-tract cancers (BTCs), with positron emission tomography (PET) scanning predicting treatment response and outcomes, according to a study published online Nov. 23 in The Lancet Oncology.

Andrew X. Zhu, M.D., of Massachusetts General Hospital Cancer Center in Boston, and colleagues examined the safety and efficacy of adding bevacizumab to gemcitabine and oxaliplatin treatment in 35 patients with advanced BTCs.

The researchers found that the median overall survival was 12.7 months and the median progression-free survival was 7.0 months. Progression-free survival was 63 percent at six months. Neutropenia, elevated alanine aminotransferase concentrations, peripheral neuropathy, and hypertension were the primary high-grade toxic effects. PET scanning using 18-fluorodeoxyglucose ([18F]FDG-PET) showed a significant decrease in maximum standardized uptake value after two treatment cycles, which was more pronounced in patients with partial response or stable disease. Changes in the maximum standardized uptake value significantly predicted progression-free survival (hazard ratio, 1.35) and overall survival (hazard ratio, 1.25).

"[The] combination of bevacizumab with gemcitabine and oxaliplatin showed anti-tumor activity with tolerable safety in patients with advanced BTCs," the authors write. "Decreases in maximum standardized uptake value on [18F]FDG-PET after treatment were associated with disease control and increases in progression-free survival and overall survival."

Several authors reported financial and consulting relationships with Genentech Oncology and Sanofi-Aventis.

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