Every patient treated for rectal cancer with an experimental immunotherapeutic drug is in remission, in the findings that researchers have hailed as a breakthrough.
All 14 patients who were given the new drug, dostarlimab, were found to have no signs of cancer after six months. Researchers at the Memorial Sloan Kettering Cancer Center in New York could not find any signs of the disease through physical examination, endoscopy, MRI or other scans.
The researchers described the results, published in the New England Journal of Medicine, as “breakthroughs” and said they were amazed at the universal success rate. “I believe this is the first time this has happened in the history of cancer,” Dr. Luis Diaz, a leading member of the team, told the New York Times.
For the patients involved – and potentially for other patients with specific types of rectal cancer that come after them – the result was dramatic. This allowed them to avoid further surgery, chemotherapy and radiation therapy by observing themselves.
This can have far-reaching consequences, especially for young adults.
“Surgery and radiation have a lasting effect on fertility, sexual health, bowel and bladder function, and the impact on quality of life is significant, especially in those where standard treatment would affect the potential for childbirth,” said another lead researcher. Andrea Chercek. “As the incidence of rectal cancer increases in young adults, this approach can have a major impact.
Dostarlimab was developed by the pharmaceutical company GlaxoSmithKline. The drug is given to patients every three to six months at a cost of $ 11,000 for each dose.
The drug is known as a checkpoint inhibitor. It works by removing the shield that cancer cells place around them, which blocks T cells in the body’s immune system from attacking them.
Without a shield, cancer cells are exposed to the immune system and are vulnerable to destruction.
The results fall into one of the most promising areas of borderline experimental cancer research, which combines personalized medicine with immunotherapy. The ambition is to train the immune system to destroy cancer cells by helping it detect specific mutations in the genetic makeup of an individual patient’s own tumor.
Researchers at Sloan Kettering have designed a clinical trial to apply to a specific subset of kidney cancer patients. All 14 patients had a rare mutation in their tumor cells known as “mismatch repair deficiency”, which means that the cell’s DNA repair system is not working.
As a result, cancer cells produce proteins with higher levels of genetic defects in them, making them more visible to the body’s immune system once the shield is removed.
Scientists involved in the dostarlimab trial are trying not to present the findings as a cure. Patients will be kept under strict medical examination to see how long they remain without cancer.
But they are optimistic about these first results. Diaz said the new treatment would be a “change of practice” for people with the type of rectal cancer.
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