Infigratinib shows promise in advanced cholangiocarcinoma
Infigratinib could offer advanced cholangiocarcinoma patients another chance at treatment, a phase II study has shown.
The fibroblast growth factor receptor (FGFR) inhibitor achieved a 23.1% objective response rate (95% CI: 15.6–32.2, 25 of 108 patients) at median follow-up 10.6 months, with one complete response in a patient who had non-target lesions identified at baseline, the authors wrote in The Lancet Gastroenterology & Hepatology.
The drug had a “manageable” safety profile, with hyperphosphataemia, stomatitis, fatigue and alopecia being the most common adverse events of any grade. Some patients also experienced dry eye and central serous retinopathy-like or retinal pigment epithelial detachment-like events, they wrote.
Patients received 125 mg of oral infigratinib once daily for 21 days of 28-day cycles until disease progression, intolerance, consent withdrawal or death.
“Treatment options are sparse for patients with advanced cholangiocarcinoma after progression on first-line gemcitabine-based therapy,” the authors wrote.
“Infigratinib has promising clinical activity and a manageable adverse event profile in previously treated patients with locally advanced or metastatic cholangiocarcinoma harbouring FGFR2 gene fusions or rearrangements, and so represents a potential new therapeutic option in this setting.”
IBD patients may be higher risk for GI symptoms with COVID-19
IBD patients may be more likely to experience new gastrointestinal (GI) symptoms with COVID-19 than the general population, according to a new study.
Of 2,917 patients in the Surveillance Epidemiology of Coronavirus Under Research Exclusion for Inflammatory Bowel Disease (SECURE-IBD) database, 764 experienced new symptoms, including diarrhoea, abdominal pain, nausea and vomiting, the authors reported in Inflammatory Bowel Diseases.
New symptoms, particularly abdominal pain, were more common in patients with active disease though still frequently observed among those in remission (29.4% vs 23.3%, P < 0.01), they wrote.
Reported rates of diarrhoea, abdominal pain, nausea and vomiting in the general COVID-19 affected population have been around 10%.
IBD patients who were older, female, of Asian race and had at least one comorbidity also had higher rates of new GI symptoms.
There was no difference in new GI symptom rates between Crohn’s disease and ulcerative colitis patients, and patients on any medication, especially anti-TNF monotherapy, were less likely to report new GI symptoms, the authors found.
Although IBD patients with new GI symptoms were more likely to be hospitalised, they were not more likely to die due to COVID-19, they said.
Australia wins bronze in healthcare service rankings
The COVID-19 ravaged UK’s National Health Service has slipped from first place to fourth in a ranking of global health services in 11 high-income countries allowing Australia to step onto the podium in third place overall.
US think tank the Commonwealth Fund’s assessment of healthcare system performance looked at 71 measures across five areas – access to care, care process, administrative efficiency, equity, and healthcare outcomes.
It found the top-performing countries overall to be Norway, the Netherlands, and Australia, followed by the UK.
Australia was first in the domains of equity and health care outcomes, second in administrative efficiency but performed less well in care process and access to care.
The UK’s drop in rankings has been attributed to the impact of the pandemic on the overall health service.
The United States ranked last overall and in all but one domain, despite spending far more of its gross domestic product on health care than other countries.
New Zealand topped the domain of care process which measures activities such as preventive care, safe care, coordinated care, and engagement and patient preferences.