Pre Surgery treatment combined with Opdivo (nivolumab) and Cabomety (cabozantinib) for hepatocellular carcinoma may reduce tumors adequately to make patients compatible for surgical resection.
We put this article together with the help of Dr. Gaurav Gupta, who provides one of the excellent liver transplants from Mumbai to explain that the combination procedure may make liver cancer patients compatible with curative surgery.
Dr. Gaurav Gupta has done the research needed and has described his views in this article. During his study, 80% of participants who were given Cabometyx and Opdivo had successful surgery.
Fatty liver
Hepatocellular carcinoma
Hepatocellular carcinoma accounts for roughly 90% of all liver cancer cases (HCC).
Early-stage HCC often has no symptoms, and many people get diagnosed late. Surgically removing a portion of the liver can help treat and even cure liver cancer in some cases.
However, less than 30% of people with HCC qualify for surgery worldwide, usually because their tumors are too large or cancer has spread.
These responses are fascinating because it suggests this strategy can be adopted for very challenging incurable diseases.
Therapies used
“Neoadjuvant therapy is used before surgery or other primary treatments to reduce tumor size or target smaller numbers of cancer cells that have spread,” says Dr. Gaurav Gupta
Cabometyx is a targeted therapy that stops cancer cells from growing. Opdivo is an immunotherapy that aids the immune system in its battle against cancer.
Dr. Gaurav Gupta says, “We wanted to use a combination that reflected the standard of care.” “This combination reflects where we believe the field is headed in terms of combining two drugs to try to maximize therapeutic effects,” says the doctor.
Twelve (80%) of the 15 patients treated with the two-drug combination underwent successful surgery, leaving no cancer cells at the resection margin.
Five of the participants (42%) had only minor cancer after treatment, indicating an excellent pathological response.
The drug combination also seemed to reduce the risk of post-surgery recurrence—five people who had significant tumor shrinkage after resection did not have a recurrence for more than 230 days.
Dr. Gaurav Gupta discovered that those who responded well to the combination therapy had more cancer-fighting T cells in their tumors, as well as a distinct pattern of B cells, implying that B cells play a role in antitumor immunity in people with HCC.
Conclusion
According to Dr. Gaurav Gupta, “A combination of the kinase inhibitor cabozantinib and the immunotherapy drug nivolumab makes curative surgery plausible in few liver cancer patients who would otherwise not be considered surgical candidates.”
FREQUENTLY ASKED QUESTIONS
When does a doctor recommend a liver transplant?
A doctor may recommend a liver transplant if a patient is diagnosed with chronic liver diseases such as Hepatitis C, Hepatitis B, cirrhosis, liver tumor, or if the liver cannot regenerate even after comprehensive treatment.
What are the signs and symptoms of a liver problem?
People with severe liver diseases will be weak, have jaundice, water retention, pass black stools or vomit blood, and experience recurrent abdominal infections.
What makes a suitable liver donor?
A healthy family member aged 18 to 55 years old with a BMI of less than 30 can be an ideal liver donor.
Is it safe to donate a liver or to have a liver transplant?
Yes, both liver donation and transplantation are highly safe procedures. The only organ in the body that can regenerate is the liver. As a result, both the donor and the recipient can expect their livers to regenerate in a few months. After a few weeks of donating liver, the donor will not need to take any medication, whereas the liver recipient will need to take anti-infection medications.
Is it true that all liver transplants are successful?
Over the last decade, Dr. Gaurav Gupta has performed nearly 500 liver transplant surgeries with excellent results. Most of them, at least. A liver transplant has a 90 percent one-year survival rate. As a result, it’s best to seek the advice of a skilled and experienced liver transplant surgeon.
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