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Since retiring as a professor ten years ago, Eden has had no plans of slowing down. She hosts her friends annually for winter activities in her home state of Utah. She has regular online gaming dates with her daughter and Zoom calls to stay connected with relatives and friends. In her retirement, she enjoys skiing and other winter activities with her husband. And of course, travel – lots of travel. With a brimming calendar, there’s always plans to look forward to just around the corner.
Despite her busy schedule, when Eden felt a lump in her left shoulder, she knew she needed to make time to have it looked at.
“I knew right away that this was something new.”
After consulting multiple doctors, undergoing numerous scans and a biopsy, she received a diagnosis: Stage IV intrahepatic cholangiocarcinoma, a form of biliary tract cancers (BTCs),1 which had spread outside of her biliary tract.
“When my doctor told me I had intrahepatic cholangiocarcinoma, I couldn’t even pronounce it let alone understand the implications. He said, ‘in other words, it’s a bile duct cancer – it’s in your liver.’”
BTCs are a group of rare gastrointestinal cancers that form in the cells of the bile ducts (known as cholangiocarcinoma) and in the gallbladder.1,2 An estimated 211,000 people are diagnosed with BTCs and gallbladder cancer each year worldwide.3
Eden’s experience is not unique. BTCs often present without clear symptoms in their earlier stages.1 In earlier stages, symptoms can be difficult to detect and can mimic gallstone attacks or ulcers.4 As the disease progresses, patients may notice non-specific symptoms or symptoms that present as a different disease.5 Symptoms may include fatigue, abdominal pain, abnormal loss of appetite, night sweats and weight loss, often contributing to delayed late-stage diagnosis.1,5 As a result, most new cases of BTCs are diagnosed at an advanced stage, when the disease is more difficult to treat.6-8
Eden has always prioritized her health, making healthy eating and exercising a part of her everyday routine. So, the diagnosis came as a shock.
“I had to tell myself that cancer is not selective. It can hit anyone, anytime, anywhere.”
Once she came to terms with her diagnosis, Eden did what Eden does – she started planning for what’s next. As a former professor, Eden appreciates the power of information.
“I did my homework. I did my research to find out everything I could about what was going on with me. I learned about all of the possible treatments and got connected with a community who understood what I was going through. I got a second opinion from a healthcare professional. Then, I committed to a plan and a treatment regimen.”
Eden’s doctor recommended an immunotherapy, IMFINZI® (durvalumab), in combination with chemotherapy (gemcitabine and cisplatin [gem-cis]).
IMFINZI is approved in the US in combination with chemotherapy (gem-cis) for the treatment of adult patients with locally advanced or metastatic BTCs based on results from the global Phase III TOPAZ-1 trial.9
After discussing the treatment with her doctor—including possible side effects—Eden and her doctor decided that proceeding with the treatment was the right path forward. The most noticeable effects from Eden’s treatment have been nausea and loss of appetite.
Important information regarding IMFINZI
IMFINZI can cause your immune system to attack normal organs and tissues in your body and affect how they work. Side effects can sometimes become severe or life-threatening and can lead to death. These problems can occur at the same time and at any time during or after treatment. See your doctor right away if you experience cough, shortness of breath, chest pain, diarrhea or other stool changes, severe stomach pain or tenderness, severe nausea or vomiting, weight changes, increased hunger or thirst, constipation, dizziness or fainting, headaches, changes in urine, eye problems, irregular or rapid heartbeat, muscle pain or weakness, fever, rash, skin blistering, chills, itching or flushing, as this may keep these problems from becoming more serious.
These are not all the possible side effects of IMFINZI. Tell your doctor about all of your medical conditions including immune system problems; if you’ve ever had an organ transplant; or are being treated for an infection.
Please see Important Safety Information below and on the IMFINZI.com website and full Prescribing Information, including Medication Guide, for IMFINZI. Eden's experience is her own. Individual results may vary. Always talk to your healthcare provider about any questions.
A BTCs diagnosis isn’t something you have to face alone. Through Eden’s research to understand more about her diagnosis she quickly found her local Cholangiocarcinoma Foundation chapter, signed up for the online support group meetings and requested a mentor who has a BTCs experience she can relate to. Learning from and leaning on those who have had a similar experience makes her feel informed and hopeful. With this community, she has found an invaluable sense of camaraderie.
Eden recognizes everyone’s experience of cancer and treatment is unique. For her, maintaining her routine and continuing to immerse herself in her community to the best of her ability is important – and her friends and family have rallied around her in support of this effort. They join her for lunch when she’s up for it, and chat over Zoom when she’s not. She exercises indoors with a senior group, and outdoors with her husband when she’s able and continues to game with her daughter online. In fact, gaming has proven to be a great way to pass time during her treatments.
As for her diagnosis?
“Cancer is just a word, it’s not a sentence.” It is with this mantra and the power of community that Eden stays positive and focused on the future.
As of May 2024, Eden is no longer receiving treatment with IMFINZI. She is exploring further treatment options and remains positive and optimistic for the future.
IMPORTANT SAFETY INFORMATION
What is the most important information I should know about IMFINZI?
IMFINZI is a medicine that may treat certain cancers by working with your immune system. IMFINZI can cause your immune system to attack normal organs and tissues in any area of your body and can affect the way they work. These problems can sometimes become severe or life-threatening and can lead to death. You can have more than one of these problems at the same time. These problems may happen anytime during treatment or even after your treatment has ended.
Call or see your healthcare provider right away if you develop any new or worsening signs or symptoms, including:
Lung problems: cough, shortness of breath, and chest pain
Intestinal problems: diarrhea (loose stools) or more frequent bowel movements than usual; stools that are black, tarry, sticky, or have blood or mucus; and severe stomach-area (abdomen) pain or tenderness
Liver problems: yellowing of your skin or the whites of your eyes, severe nausea or vomiting, pain on the right side of your stomach area (abdomen), dark urine (tea colored), and bleeding or bruising more easily than normal
Hormone gland problems: headaches that will not go away or unusual headaches; eye sensitivity to light; eye problems; rapid heartbeat; increased sweating; extreme tiredness; weight gain or weight loss; feeling more hungry or thirsty than usual;urinating more often than usual; hair loss; feeling cold; constipation; your voice gets deeper; dizziness or fainting; and changes in mood or behavior, such as decreased sex drive, irritability, or forgetfulness
Kidney problems: decrease in your amount of urine, blood in your urine, swelling of your ankles, and loss of appetite
Skin problems: rash; itching; skin blistering or peeling; painful sores or ulcers in mouth or nose, throat, or genital area; fever or flu-like symptoms; and swollen lymph nodes
Pancreas problems: pain in your upper stomach area (abdomen), severe nausea or vomiting, and loss of appetite
Problems can also happen in other organs and tissues. These are not all of the signs and symptoms of immune system problems that can happen with IMFINZI. Call or see your healthcare provider right away for any new or worsening signs or symptoms, which may include: Chest pain, irregular heartbeats, shortness of breath or swelling of ankles; confusion, sleepiness, memory problems, changes in mood or behavior, stiff neck, balance problems, tingling, numbness or weakness of the arms or legs; double vision, blurry vision, sensitivity to light, eye pain, changes in eye sight; persistent or severe muscle pain or weakness, muscle cramps, joint pain, joint stiffness or swelling; and low red blood cells and bruising
Infusion reactions that can sometimes be severe or life-threatening. Signs and symptoms of infusion reactions may include: chills or shaking, itching or rash, flushing, shortness of breath or wheezing, dizziness, feel like passing out, fever, and back or neck pain
Complications, including graft-versus-host disease (GVHD), in people who have received a bone marrow (stem cell) transplant that uses donor stem cells (allogeneic). These complications can be serious and can lead to death. These complications may happen if you underwent transplantation either before or after being treated with IMFINZI. Your healthcare provider will monitor you for these complications
Getting medical treatment right away may help keep these problems from becoming more serious. Your healthcare provider will check you for these problems during your treatment with IMFINZI. Your healthcare provider may treat you with corticosteroid or hormone replacement medicines. Your healthcare provider may also need to delay or completely stop treatment with IMFINZI if you have severe side effects
Before you receive IMFINZI, tell your healthcare provider about all of your medical conditions, including if you:
- have immune system problems such as Crohn's disease, ulcerative colitis, or lupus
- have received an organ transplant
- have received or plan to receive a stem cell transplant that uses donor stem cells (allogeneic)
- have received radiation treatment to your chest area
- have a condition that affects your nervous system, such as myasthenia gravis or Guillain-Barré syndrome
- are pregnant or plan to become pregnant. IMFINZI can harm your unborn baby
Females who are able to become pregnant:- Your healthcare provider will give you a pregnancy test before you start treatment with IMFINZI.
- You should use an effective method of birth control during your treatment and for 3 months after the last dose of IMFINZI. Talk to your healthcare provider about birth control methods that you can use during this time.
- Tell your healthcare provider right away if you become pregnant or think you may be pregnant during treatment with IMFINZI.
- are breastfeeding or plan to breastfeed. It is not known if IMFINZI passes into your breast milk. Do not breastfeed during treatment and for 3 months after the last dose of IMFINZI.
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
What are the possible side effects of IMFINZI?
IMFINZI can cause serious side effects (see above):
The most common side effects of IMFINZI when used with other anticancer medicines in people with BTC include feeling tired, nausea, constipation, decreased appetite, stomach (abdominal) pain, rash, and fever.
Tell your healthcare provider if you have any side effect that bothers you or that does not go away. These are not all the possible side effects of IMFINZI. Ask your healthcare provider or pharmacist for more information.
Call your doctor for medical advice about side effects. You may report side effects related to AstraZeneca products (opens new window). If you prefer to report these to the FDA, either visit www.FDA.gov/medwatch or call 1-800-FDA-1088.
What is IMFINZI?
IMFINZI is a prescription medicine used to treat adults with a type of cancer called biliary tract cancer (BTC), including cancer of the bile ducts (cholangiocarcinoma) and gallbladder cancer. IMFINZI may be used in combination with chemotherapy medicines gemcitabine and cisplatin when your BTC has spread to nearby tissues (locally advanced), or has spread to other parts of the body (metastatic).
It is not known if IMFINZI is safe and effective in children.
Please see Full Prescribing Information including Medication Guide for IMFINZI.
References
- ESMO. What is biliary tract cancer. Accessed February 2024. Available at: https://www.esmo.org/content/download/266801/5310983/1/EN-Biliary-Tract-Cancer-Guide-for-Patients.pdf.
- Woods E, et al. Changing landscape of systemic therapy in biliary tract cancer. Cancers (Basel). 2022;14(9):2137.
- Ouyang G, et al. The global, regional, and national burden of gallbladder and biliary tract cancer and its attributable risk factors in 195 countries and territories, 1990 to 2017: A systematic analysis for the Global Burden of Disease Study 2017. Cancer. 2021;127(13):2238-2250.
- Huang D, et al. Association between gallstones and the risk of biliary tract cancer: a systematic review and meta-analysis. Epidemiol Health. 2021;43:e2021011.
- Garikipati SC, Roy P. Biliary tract cholangiocarcinoma. [Updated February 6, 2023]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; January 2023.
- Shroff RT, et al. Adjuvant therapy for resected biliary tract cancer: ASCO Clinical Practice Guideline. J Clin Oncol. 2019;37(12):1015-1027.
- Turkes F, et al. Contemporary tailored oncology treatment of biliary tract cancers. Gastroenterol Res Pract. 2019:7698786.
- Rawla P, et al. Epidemiology of gallbladder cancer. Clin Exp Hepatol. 2019;5(2):93-102.
- IMFINZI® (durvalumab) [Prescribing Information]. Wilmington, DE: AstraZeneca Pharmaceuticals LP; 2023.
IMFINZI is a registered trademark of the AstraZeneca group of companies.
©2024 AstraZeneca. All rights reserved. US-84556 Last Updated 2/24
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