Empower Our Patients – Increase Their Survival.
Empower their Community and Workplaces – Exponentially Increase Survival

“We, work to ensure that today’s research and knowledge are fully utilised and integrated into today’s patient toolkit. By simplifying both the science and the knowledge into a format that patients and caregivers can understand and effectively apply, we help achieve this” ~ Steve Holmes 

This article is about

Picture your mind as a battlefield. In the complex fight against cholangiocarcinoma, understanding and clarity are our greatest allies. Imagine the cancer as a fortified enemy stronghold. To conquer it, we need a coordinated battle plan where each component of our arsenal plays a crucial role. This is where the combination of immunotherapy and Gem/Cis (Gemcitabine and Cisplatin) comes into play.

Introduction to Cell City (s)

By Professor Guzzba: 

Hello again! I’m Professor Guzzba, a fictional Molecular Biologist and Scientist Character, my job is to simplify the complex into a manner that you can better understand and effectively apply.

I will now guide you through an animated explanation of this clinical trial. Firstly, let’s get you acquainted with a ‘Cell City.’ We have trillions of cell cities in our body’s universe. Cells that cluster together fire together, which simply means liver cells make liver, bile duct cells make bile ducts, and bile cells make bile, and so on. Each cell is a vibrant and bustling city within our bodies with its own specific city function, ensuring the well-being of its cluster and our body’s entire eco-universe.

Each city has a town hall (nucleus) packed with city planners and blueprints on how to run the city (genes) and their messengers (mRNA) that carry the messages to the city’s factory plants (ribosomes) that build everything the city needs to remain healthy. But sometimes, things go wrong. The genes get damaged, and the messages to the factories become chaotic, causing the factories to begin manufacturing faulty parts. This is when Cell City falls into chaos and can turn a cell rogue.

Normally, our body’s immune system steps in to help the city planners correct their mistakes, but sometimes cancer gets there first and takes over. Cancer’s first mission is to evade the immune system by stealth or false pretenses and grow its own clusters. Cancer likes to keep its tumor environment cold (cold tumors) and quiet so it can continue to grow under the radar. In some cases, the immune system does recognize and attacks the cancerous cells; this battle turns the environment into a hot tumor. Another way to understand this is that a quiet party (cold tumor) doesn’t attract attention, while a loud party (hot tumor) does. This is where every cancer story begins and the primary focus of introducing a clinical trial—to turn cold tumors hot.

Please Note: I am a fictional Molecular Biologist and Scientist Character, my job is to simplify the complex into a manner that you can better understand and effectively apply.

Ok so let’s get back to today’s article: Understanding Immunotherapy in Combination with Gem/Cis: A Strategic Battle Plan.

Think of Gemcitabine and Cisplatin as the infantry and artillery in our battle. These chemotherapy agents attack the cancer cells head-on, bombarding them from multiple fronts.

• Gemcitabine: This agent acts like precise artillery, targeting the DNA of cancer cells. By incorporating itself into the DNA during replication, Gemcitabine causes the cancer cells to die when they attempt to divide.
• Cisplatin: Cisplatin is the heavy infantry, creating cross-links in the DNA of cancer cells, which makes it difficult for the cells to repair themselves, leading to cell death.

This initial assault weakens the cancer cells, creating vulnerabilities in their defenses. Gem/Cis works to disrupt the cancer cells’ ability to grow and divide, making them more susceptible to further attacks.

Once the infantry and artillery have done their job, the special immunotherapy forces move into position. They are trained to identify specific protein biomarkers on the surface of cancer cells, block their function, and flag the cell for destruction by our immune system. Immunotherapy helps rev up and guide the immune system to attack with pinpoint accuracy and eliminate that cancer.

Think of it like this:  Your doctors are the generals who send in a special elite unit that navigates the battlefield with precision, targeting the most crucial and vulnerable parts of the enemy’s defenses. This approach maximizes the effectiveness of the treatment by using your body’s natural defenses to finish what the chemotherapy started.

The true power of this combination lies in its synergy. By weakening the cancer cells first, Gem/Cis sets the stage for an effective immunotherapy strike which will be far more effective. The chemotherapy agents break down the cancer’s defenses, and then immunotherapy enhances your immune system’s ability to identify and destroy these weakened cells. It’s a one-two punch followed by a precision strike that increases the chances of a successful outcome.

Knowledge is power in this fight against cancer, so please take a moment to pause and find your own rhythm within this challenge you now find yourself in.

It will always appear overwhelming at first glance, so if you need a moment that’s fine, take it, as patients we all need to let it out.

Please understand there is no right way to reach your point of understanding, it is not a race, we are all different, so any way you get there is the right way. The important thing is you understand this treatment strategy in a manner you can apply it. This will be your start line and your biggest weapon against cancer.

Understanding increases effective engagement and effective engagement leads to more successful outcomes.

More effectively means you move from being in the passenger seat to the captain’s seat of your challenge, with the co-pilots who have the expertise and experience in your exact diagnosis right alongside you.

Every battle has its challenges, and managing side effects is a crucial part of this Gem/Cis/Immuno strategy. Common side effects of Gem/Cis include nausea, fatigue, and low blood cell counts. Immunotherapy can cause immune-related side effects, which require careful monitoring. Knowing what to expect and how to manage these effects can significantly improve your quality of life during treatment.

Your doctor will need to be experienced in this exact strategy, you should also familiarise yourself with them.

When you understand this article then you have taken a strong step forward, you have begun to better equip and empower your capacity to more effectively respond, survive and thrive beyond your diagnosis and prognosis. By understanding the synergy between immunotherapy and Gem/Cis, you and your caregivers can navigate the treatment journey with more confidence.

When responding to a cholangiocarcinoma diagnosis, we must move forward with bold deliberation and persistent creativity. We must be open-minded and act with unrestricted willingness, that is how we as patients generate the perseverance and endurance needed to flip cancer on its head and break its grip.

Together, we can turn today’s scientific breakthroughs into today’s patient survival, transforming cholangiocarcinoma from a dire prognosis to a manageable condition.

You may also like to read The-basics-differences-between-gem-cis-with-durvalumab-vs-keytruda