Remarkable & Unprecedented

Sascha Roth, left, Luis Diaz, Imtiaz Hussain, Andrea Cercek, Avery Holmes and Nisha Varughese. (Courtesy of Memorial Sloan-Kettering Cancer Center)

“I believe this is the first time this has happened in the history of cancer.” 

It’s a bold statement, but the results from a cancer trial that left every patient in remission might give Dr. Luis A. Diaz Jr. an excellent reason to exclaim them. And according to the New York Times article, the study was small, and experts say it needs to be replicated, but the outcome for 18 people with rectal cancer led to “happy tears.” 

The study is being praised as “unprecedented” and “remarkable.”

Dr. Luis A. Diaz Jr. published the findings in a paper published on Sunday in The New England Journal of Medicine. It outlined the study of 18 rectal cancer patients who were given intravenous infusions of dostarlimab every three weeks for six months and ended up cancer-free, including the first patient who is now two years out from the trial.

Co-author Dr. Andrea Cercek, an oncologist at Memorial Sloan Kettering Cancer Center, was the one who proclaimed, “I believe this is the first time this has happened in the history of cancer.” She was also the one who said there were “a lot of happy tears” at the end of the trial.

The study stated that researchers “initiated a prospective phase 2 study in which single-agent dostarlimab, an anti–PD-1 monoclonal antibody, was administered every 3 weeks for 6 months in patients with mismatch repair-deficient stage II or III rectal adenocarcinoma. This treatment was to be followed by standard chemoradiotherapy and surgery.”

According to The Times, those who took the drug did not have to move on to further cancer treatments.

The drug “unmasks cancer cells, allowing the immune system to identify and destroy them,”. In other words, the patient’s own immune system was able to kill the cancer without any more invasive treatment.

Hanna K. Sanoff, MD, MPH of UNC Lineberger Comprehensive Cancer Center, cautions, “These initial findings of the remarkable benefit with the use of dostarlimab are very encouraging but also need to be viewed with caution until the results can be replicated in a larger and more diverse population.” 

The doctors and researchers are careful not to use words like “cured,” but the point remains: All of the trial patients were completely cancer free at follow-up, and all without the most invasive traditional interventions like chemo, radiation, and surgery.

Research into cancer has revealed that every tumor is unique. It is for that reason that some people respond well to certain treatments while others don’t. All of the patients in this study were specifically chosen based on their tumor’s likelihood of responding well to this particular drug. In other words, this is not a panacea for all cancers… but the results for this very specific type of tumor are very encouraging.

“The responses in these first 12 of a planned-for 30 patients in the trial were remarkable and exceed what we would expect with the standard chemotherapy plus radiation,” Dr. Sanoff continued. “Although quality of life measures have not been reported yet, it’s encouraging that some of the most difficult symptoms, such as pain and bleeding, all resolved with the use of dostarlimab.”

We’ll take “remarkable,” “unprecedented,” and “encouraging” when it comes to cancer treatments!

https://www.nytimes.com/2022/06/05/health/rectal-cancer-checkpoint-inhibitor.html

http://www.nejm.org/doi/full/10.1056/NEJMoa2201445

https://www.cancer.gov/about-cancer/treatment/drugs/dostarlimab-gxly

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