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Health Rounds

By Nancy Lapid, Health Science Editor

Hello Health Rounds readers! Today we lead off with an encouraging study in which men with sexual dysfunction after treatment for prostate cancer experienced improvements by taking part in a supervised exercise program. We also report on a late-stage study in which a new drug combination extended the survival of patients with inoperable liver cancer. Finally, we share findings from U.S. public health officials who want primary care physicians to become more aware that some tick bites are causing allergies to red meat at an increasing rate.

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Surgery and other treatments for prostate cancer can leave lpersistent sexual function problems, but prostate cancer survivors reported improvements in sexual dysfunction after participating in supervised exercise programs. REUTERS/Rosem Morton

Study Rounds

Exercise improves sexual function after prostate cancer

Patients with sexual dysfunction after prostate cancer treatment can immediately benefit from supervised exercise interventions to improve their sexual health, researchers said.

They randomly assigned 112 patients to receive six months of supervised, group-based resistance and aerobic exercise three times a week; the same exercise program plus a brief self-managed psychosexual intervention; or usual care.

Both exercise groups reported improved erectile function and intercourse satisfaction compared with the usual care group, study leader Daniel Galvao from Edith Cowan University in Perth, Australia will report later this week at the 2023 American Society of Clinical Oncology (ASCO) Breakthrough Meeting in Yokohama, Japan.

Exercise also prevented an increase in fat mass and improved upper and lower body muscle strength and other physical function outcomes.

The psychosexual therapy, which involved one brief session with a counselor plus self-help materials on erectile dysfunction and stress management, resulted in no additional improvements.

More research is needed to see how long the effects last, the researchers said. Meanwhile, Galvao said in a statement that "exercise should be considered as an integral part of treatment for prostate cancer."

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Drug combo improves survival with inoperable liver cancer

An experimental drug combination is moving closer to becoming a new initial treatment for inoperable liver cancer after it significantly improved survival in a late stage randomized trial of patients with newly diagnosed hepatocellular carcinoma (HCC) not eligible for surgery, researchers reported.

The combination of camrelizumab plus rivoceranib being developed by HLB Inc's U.S. subsidiary Elevar Therapeutics showed a statistically significant and clinically meaningful benefit in helping patients live longer compared with Bayer's Nexavar (sorafenib), the current standard of care.

The combination also helped the disease to remain stable without progressing for longer, according to a report published in The Lancet.

In the 543-patient trial, half of those who received the combination therapy lived at least 22.1 months, while median overall survival with Nexavar was 15.2 months.

"To our knowledge, the median overall survival of 22.1 months in the camrelizumab/rivoceranib group was the longest one observed for any systemic treatment in global Phase 3 trials in unresectable hepatocellular carcinoma," the researchers wrote.

Progression-free survival, or the time until the cancer began to worsen, was an average of 5.6 months in the camrelizumab/rivoceranib group, versus 3.7 months for Nexavar.

The new drug did not present any notable safety issues, the researchers said.

In mid-July, the U.S. Food and Drug Administration accepted Elevar's application for rivoceranib in combination with camrelizumab as a first-line, or initial, treatment for inoperable HCC.

U.S. clinicians unfamiliar with tick-borne red meat allergy

Many U.S. primary care providers are ill equipped to recognize and treat increasingly common allergic reactions to red meat and other food products such as from pigs, goats, cows and sheep, according to a report from the U.S. Centers for Disease Control and Prevention (CDC).

In the CDC's nationwide survey of 1,500 primary care providers, 42% were not aware of so called alpha-gal syndrome, also called red meat allergy or tick bite meat allergy. Another 35% were not confident in their ability to diagnose or manage it in their patients, researchers wrote on Friday in the CDC's Morbidity and Mortality Weekly Report.

Alpha-gal is a sugar molecule found in nonprimate mammals. Ticks ingest alpha-gal when they bite into these mammals and transmit it by biting people.

Once in the human bloodstream, alpha-gal triggers a potentially life-threatening allergic response from the immune system if the person eats red meat or other products containing alpha-gal, such as milk or cheese, or gelatin-coated medications.

Earlier research suggests that nearly 80% of patients go undiagnosed for more than seven years, the CDC researchers said.

A second study published in the same issue found the annual number of confirmed new diagnoses of alpha-gal syndrome in the United States rose from 13,371 in 2017 to 18,885 in 2021. Most cases occurred in areas with lone star ticks, particularly throughout Arkansas, Kentucky, Missouri, and Suffolk County, New York, although clusters of cases also occurred in areas without known established populations of the insects.

"The burden of alpha-gal syndrome in the United States could be substantial given the large percentage of cases suspected to be going undiagnosed due to non-specific and inconsistent symptoms, challenges seeking healthcare, and lack of clinician awareness," Dr. Johanna Salzer, senior author on both papers, said in a statement.

Companies developing pig organs for human transplantation and other medical procedures have managed to genetically engineer the animals to be alpha-gal free. In 2020, the U.S. Food and Drug Administration approved Revivicor's GalSafe pigs to be used both for human food and therapeutics.

This newsletter was edited by Bill Berkrot. Additional reporting by Shawana Alleyne-Morris.

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