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Cancer Care Innovations: Recently approved therapy improves the odds for liver cancer patients

Bill Quilty lives near Fresno, so when his doctor recommended he drive 200 miles to UCLA Health to get treatment for his newly diagnosed liver cancer, Quilty wanted to know why he couldn’t stay closer to home.

“Because I’m trying to save your life and this is where you need to go,” his doctor told him.

Quilty took his doctor’s advice and believes it’s the reason he is still alive. In the past year, his liver tumors have shrunk. And his tumor marker numbers have plummeted from a whopping 645 to a healthy 3 (the normal range is 7 or lower).

“It’s phenomenal,” says Quilty, 63.

He thanks liver cancer specialist Dr. Richard Finn.

Finn, who is director of the signal transduction and therapeutics program at UCLA Jonsson Comprehensive Cancer Center, was the “principal investigator” for the new cancer-fighting cocktail that Quilty takes.

The immunotherapy combination received FDA approval in June 2020, only two months before Quilty was diagnosed.

While the therapy is a big win in the battle against liver cancer, Finn says, it  didn’t make big headlines, getting lost in the storm of COVID-19 media coverage last summer. But it is prolonging a lot of lives.

Globally, liver cancer is the third leading cancer killer, taking 830,000 lives in 2020, according to the World Health Organization. It is the fastest growing cancer in the United States (42,000 new cases are projected this year), spurred by “an epidemic of undiagnosed liver disease,” according to Finn.

The main driver of liver disease here is hepatitis, which leads to chronic inflammation and eventually cancer. Fatty liver disease, most often triggered by obesity and diabetes, is the other risk factor. Quilty is diabetic.

Finn stresses that, if found early, liver cancer can be burned off or cut out. The problem, though, is that there aren’t any symptoms until it is advanced, so few people catch it in time.

By the time Quilty was diagnosed, there was so much cancer that removal of it would have left very little liver.

For years, the standard liver cancer treatment bought patients maybe eight months. In 2018, other drugs started to come along that slowed tumor growth, pushing survival rates to 13 months.

Then researchers started to play around with combinations that would not only slow tumor growth, but shrink existing tumors.

Dr. Richard Finn, of UCLA’s Jonsson Comprehensive Cancer Center, is the lead researcher into a new type of liver cancer treatment that was recently approved by the FDA. Finn poses at Ronald Reagan UCLA Medical Center in Westwood on Wednesday, September 15, 2021. (Photo by Sarah Reingewirtz, Los Angeles Daily News/SCNG)

Finn was one of the global leaders who helped design the IMbrave 150 study in 2017. It combines the monoclonal antibody Tecentriq with Avastin, a drug that targets blood vessels, inhibiting tumors.

“The real exciting thing with this combo, is that patients are living over 19 months,” says Finn. “It’s really a game changer. It is the new standard of care.”

Side affects are less harsh than earlier treatments.

“It’s really striking,” Finn says.

Quilty says side effects for him include fatigue and body aches. He cut back his hours as a real estate appraiser, but still has the energy to ride his Harley, go duck hunting near his home in Hanford and visit with his grandkids.

“We’ve moved the football up the field,” says Finn. “Now we need to figure out how to keep that momentum going.”

When Finn isn’t seeing patients (two days a week), he is in his lab trying to come up with other therapeutic cocktails. He is currently involved with a phase three trial for another immunotherapy combo.

“That’s another one that is very exciting,” he says. “The future is now these combinations.”

And early detection.

“Everybody knows to do a mammogram or colonoscopy,” he says.

The only surefire way to check for liver disease is with an ultrasound. That’s how Quilty found out. His doctor ordered a scan just to take a peek at his liver because his blood sugar had been acting wonky.

Finn says Quilty’s case should give hope to other patients.

“His tumor is still shrinking on every scan every few months,” he says. “Maybe he’ll just keep going. Maybe he’ll be cured. I don’t know. It’s really exciting to see. It’s a reason for patients not to give up.”

Quilty says he is glad he took his doctor’s advice and made that first long drive to UCLA. At this point he could receive the treatment at a medical facility closer to home, but he has declined, preferring to stick with Finn.

“You don’t pull Tom Brady out of the Super Bowl in the middle of the game,” he says, laughing. “Dr. Finn is awesome. I appreciate him every day.”

So every 21 days he drives south for three hours, sits in a chair for a three-hour therapy IV drip, and then drives back home.

For Finn, it’s personal. He was in high school in Torrance when his own mom got breast cancer and later died in 1988. It’s why he went to medical school to become an oncologist.

“I’m very humbled and blessed to make a contribution,” he says.



Source: Orange County Register

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