In 2020, nearly 340,000 people died of rectal cancer. Now a new treatment that gives hope to beat the disease, and perhaps also for other forms of cancer, could be available in a year.
A recent trial, conducted by researchers at the Memorial Sloan Kettering Cancer Center and published in the New England Journal of Medicine on June 5, produced almost unprecedented results: 14 out of 14 patients are in remission up to two years after treatment. . Four more people are still in treatment
Even better, the drug dostarlimab has shown no side effects or drawbacks, unlike other treatments. “Radiation is effective in removing the tumor, but it negatively affects the patient. Up to thirty percent of those who undergo surgery need colostomy bags,” Dr. Andrea Cercek, a Sloan Kettering oncologist and co-author, told The Post. of the study. ” [Radiation] it can also cause sexual dysfunction. They improve but they are not functionally equal. “
According to Cercek, the probability of the 14 case studies being in remission is one in one trillion. Based on that, he said, “I’m very optimistic about success.”
She hopes to see the FDA-approved drug “as soon as possible.”
Andrea Cercek, a Sloan Kettering oncologist with patient Imtiaz Hussain, expects dostarlimab to be accelerated by the FDA. Memorial Sloan Kettering Cancer
But Dr. Siddhartha Mukherjee, a biologist, physician and author of the Pulitzer Prize-winning “Emperor of All Diseases: A Biography of Cancer,” warns that it may be too early for champagne to come out.
“I was thrilled that this drug has such an incredible response rate,” Mukherjee told The Post. “I’d like to see it repeated in a big rehearsal. It’s the kind of result that makes people in our field excited but also apprehensive.”
He also warned that the treatment, which he believes could have widespread use in a year, was aimed at a very specific population.
Cancer experts say that the drug dostarlimab could be useful with other forms of cancer, if patients have a certain gene.
“Patients [in the study] they were carefully selected and are being treated with a specific form of cancer that is receptive to this drug, “he said.
According to Cercek, all 18 case studies had a form of rectal cancer in which a gene mutation inhibits their cells from repairing DNA damage.
Cercek said only 5 to 10 percent of people with rectal cancer have this gene, which works poorly because it doesn’t hide well from medication. As a result, the drug, which boosts the immune system, is very effective.
All patients in Sloan Kettering’s study had a form of rectal cancer in which a gene mutation inhibits their cells from repairing DNA damage. NEJM
“Stomach, pancreatic and bladder cancers have cells with these dysfunctions in similar percentages,” he said. “It can also work on these. Our plan is to expand and see if it does. I think it’s very likely.”
Mukherjee said the type of drug used in the study, known as a control point inhibitor, is not new: control point inhibitors have been around since 2014 and prevent cancer cells from hiding from the system. immune system, but the selective orientation of patients is surprising.
‘Exciting potential’
“Many trials have shown response rates in patients using this family of drugs, but I haven’t seen a 100 percent response rate,” he said. “It rejuvenates the idea of using this family of drugs in other cancers. The potential for it to work with other cancers at this response rate is very exciting.”
Sascha Roth, now in remission, is surprised that she has not experienced any side effects with dostarlimab.Memorial Sloan Kettering Cancer
Test participant Sascha Roth was about to arrive at Georgetown University Medical Center for chemotherapy rounds, treatments that rarely work against mutated rectal cancer cells when she went to Sloan. Kettering to get another opinion.
“Editions were underway with the FDA for final approval [to run trials]Roth, now 41, told The Post. “Then they told me she would be the perfect partner for treatment. Two months later, in December 2019, they treated me.”
Treatment involved a 60-minute infusion of dostarlimab every three weeks, for a total of nine doses. Roth said he felt no side effects and hoped for the best.
Patients Sascha Roth, Imtiaz Hussain, Avery Holmes and Nisha Varughese with researchers Drs. Luis Diaz and Andrea Cercek.Memorial Sloan Kettering Cancer
“After the first month and a half, the biopsies showed that the cancer was being eliminated. It just melted, “she said, still sounding like a person in the new cloud.” After six months, Dr. Cercek called and asked if I was sitting. She was looking at a scan and told me there was no “Absolutely no cancer. I didn’t cry when I heard the news. I was really surprised. But I jumped up and down.”
Regarding the following, Cercek said, “We focus on rectal cancer, make sure we can approve it, and continue our efforts to resolve other tumors. We also need to find out what these tumors have and the environments in which they live. which makes them so sensitive to therapy. “
Anticipating that researchers around the world will work on it, he said: “I think it will be the next big search for the treasure of medicine.”