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A new combination drug therapy shows promise in treating patients with advanced biliary-tract cancers, researchers say.

The study from the Massachusetts General Hospital Cancer Center in Boston found that survival and tumor response in patients treated with bevacizumab (Avastin), an angiogenesis inhibitor that has helped slow the growth of other cancers, in addition to the chemotherapy regimen of gemcitabine and oxaliplatin — a combined treatment called GEMOX-B — was comparable to findings in previous studies in which patients were treated with gemcitabine and oxaliplatin alone.

In the new phase 2 trial, 35 biliary-tract cancer patients were given all three drugs intravenously (bevacizumab at 10 milligrams per kilogram, followed by gemcitabine at 1,000 milligrams per square meter, and oxaliplatin at 85 milligrams per square meter) on days 1 and 15, every 28 days. Whole-body PET scans were used to assess patients at the start of the study and at the end of the second cycle of treatment.

The researchers found that the overall tumor response rate was 40 percent (14 patients with confirmed partial responses) and stable disease was noted in another 10 patients (29 percent). The overall survival was found to be 12.7 months, with a median progression-free survival of seven months. However, progression-free survival at six months was below the targeted rate at 63 percent, they noted.

The most common negative side effects of GEMOX-B therapy were fatigue, an abnormally low number of white blood cells, peripheral neuropathy, high blood pressure and gastrointestinal problems, but the therapy was generally well-tolerated, the study authors pointed out.

The findings add to increasing evidence “supporting the combination of molecularly targeted agents with chemotherapy to further improve treatment outcomes in patients with biliary-tract cancers,” the researchers wrote.

A socially isolated, stressful environment can speed up the growth of breast cancer, researchers studying the effects of stress in animal models reported Tuesday.

Social isolation can actually change the expression of genes important in the growth of mammary gland tumors, according to Dr. Suzanne D. Conzen, an associate professor of medicine at the University of Chicago and the study’s lead author.

“As far as we know, this is the first assessment of gene expression in mammary glands, looking at the molecular basis for differences in tumor development under the setting of social stress,” Conzen said at a news conference Tuesday.

The findings, published in the October issue of Cancer Prevention Research, follow other studies, some in humans, that showed stress can adversely impact cancer. One study, for instance, found that stressful marriages are bad for breast cancer recovery.

Conzen and her colleagues randomly assigned mice that were genetically susceptible to breast cancer to live either in isolation or in group housing.

“We separated the mice at a very young age, just a few days after they had been weaned from their mothers’ milk,” Conzen said. “Mice are social animals. In the wild, they live in groups of three or four. They have dramatic responses to isolation.”

“What we found was the isolated mice developed larger and more breast cancers than the group-housed mice,” she added.

Three and a half weeks into the isolation, Conzen’s team measured gene expression in the animals’ mammary glands, the equivalent of the human breast. “We found very reproducible changes in gene expression [in the isolated mice]. We found genes that were turned on and turned off that had to do with metabolism,” she said. These pathways are known to contribute to increased growth of breast cancer, she added.

The isolated mice also had a higher corticosterone stress hormone response than did the group-housed mice.

The changes in the expression levels of metabolic pathway genes occurred in the isolated mice even before the tumor size differences were able to be measured, Conzen said.

So what are the practical applications of the research?

The findings may suggest molecular biomarkers, or targets, for preventive intervention in breast cancer, she said.

“Many questions remain,” Conzen added. “One of the things we did note is that the isolated animals were much more vigilant, less exploratory. They released more of a stress hormone when we added another stressor to the situation [besides the isolation].”

Thea Tisty, a pathology professor at the University of California, San Francisco, who is familiar with the findings, called the research “a very exciting beginning.”

The implication is that perceived or actual stress from outside can affect which genes get turned on or off. If the research findings bear out, it could lead to a way to catch tumors in their formation before they become tumors and suppress them, she said.

Another expert speaking at the briefing cautioned that the findings, while exciting, are only preliminary and based only on animal studies.

“This is an area that has a long way to go in terms of understanding how these factors play out in humans,” said Caryn Lerman, the Mary W. Calkins Professor of Psychiatry at the Abramson Cancer Center at the University of Pennsylvania in Philadelphia.

An ancient Chinese herbal remedy called “thunder god vine” helps reduce inflammation in people with rheumatoid arthritis, a new study shows.

The remedy is an extract of the medicinal plant Tripterygium wilfordii Hook F (TwHF) — known in China as “lei gong teng” — and has been used for centuries to treat a variety of inflammatory diseases.

The study compared reduction in joint swelling among people with rheumatoid arthritis who took either the herb or an anti-inflammatory drug.

Rheumatoid arthritis causes chronic and painful inflammation of the joints that, over time, can lead to joint damage and loss of function.

The 121 participants in the study all had at least six swollen joints. One group took 60 milligrams of TwHF root extract three times a day, and the others 1 gram of sulfasalazine (Azulfidine), a prescription anti-inflammatory drug, twice a day.

After 24 weeks, about 65 percent of those taking the herbal extract showed at least a 20 percent improvement in their joints, based on American College of Rheumatology criteria, a standard measure of the effectiveness of arthritis treatments. About 33 percent of those taking sulfasalazine improved to that degree.

A report on the findings is published Aug. 18 in Annals of Internal Medicine.

“This study is a reminder of the potential importance of supplements and herbs in the management of arthritis,” said Dr. John H. Klippel, president and chief executive of the Arthritis Foundation.

Even so, the study involved a relatively small number of people, Klippel noted. Clinical trials for pharmaceuticals typically involve many more participants studied over several years, he said.

“The findings are encouraging, but [TwHF] is not likely to be recommended by rheumatologists based on the findings of this one study alone,” Klippel said.

And, though sulfasalazine used to be very popular as an arthritis treatment, the drug is not used that often today in the United States, according to Dr. Stephen Lindsey, head of rheumatology at Ochsner Health Systems in Baton Rouge, La.

Methotrexate (Rheumatrex, Trexall) is the drug most often used today, he said.

“I would be optimistic that an herbal medicine would play some role in improving rheumatoid arthritis,” Lindsey said. But he added that he “would be a little bit wary since the medicine they compared it to is a fairly mild, anti-rheumatoid agent and not the standard drug used in the U.S.”

Other alternative remedies, he said, have proven helpful for arthritis, including fish oil, though some of them have not held up to more rigorous studies.

Participants in the new study were allowed to continue taking oral prednisone or nonsteroidal anti-inflammatory drugs, but anyone who was taking disease-modifying anti-rheumatic drugs (such as methotrexate), which slow the progression of the disease, had to stop taking them about a month before the study began.

Researchers did not see a statistically significant difference in joint damage on X-rays, Klippel said. But he said that probably was because six months wasn’t long enough for noticeable changes.

The study also had a high dropout rate, with 62 percent of those taking TwHF and 41 percent of the others continuing to the end. According to the study, 17 people taking sulfasalzine and 8 taking TwHF dropped out because of adverse effects — most often gastrointestinal symptoms, including nausea and diarrhea.

Lindsey noted that people should always remember to tell their doctor if they are taking an herbal supplement.

“Just because something is herbal doesn’t mean it’s going to be cheap or safe,” he said.