Experimental treatment eliminated rectal cancer tumors in a small study groupExBulletin

SACHA PFEIFFER, Host:

Only a few people with rectal cancer have experienced something like a miracle. Their cancer simply disappeared after treatment. In a very small study, these patients took a drug called Dostarlimab for 6 months and eventually all saw the tumor disappear. Well, this trial was small, with only 18 people, but there’s still more to learn about how the treatment worked. However, some scientists say that this kind of result has never been seen in the history of cancer research.

So, talking more about this is Dr. Hannah Sanov of the Rheinberger Comprehensive Cancer Center at the University of North Carolina. She is not involved in her research. This was done by a doctor at the Memorial Sloan Kettering Cancer Center in New York. But Dr. Sanov writes about the results. Welcome to the program.

Hannah Sanov: Thank you.

Pfeiffer: Now we are usually very cautious about focusing on very small studies, but we have a very cautious enthusiasm for this and wanted to talk about it. Please tell me the reaction when you hear the result.

Sanov: Of course. So I’m incredibly optimistic. As you said at the beginning, I’ve never seen anything work for 100% of people with cancer treatment.

Pfeiffer: It should be noted that rectal cancer may include chemotherapy, radiation therapy, surgery, or a combination of all of them. How does this medicine work?

SANOFF: This drug is one of a class of drugs called immune checkpoint inhibitors. And these are immunotherapeutic drugs that act by actually acting essentially on the human immune system, rather than directly attacking the cancer itself. And while these have been present in melanoma and other cancers for quite some time, they are actually drugs that were not part of the routine care of colorectal cancer until quite recently.

Pfeiffer: And drugs usually have side effects. What side effects did this have?

Sanov: Very few in this study-in fact, surprisingly few. Most people had no serious adverse effects.

Pfeiffer: You used to say that this clinical trial is changing the practice in this area. How do you see it as a change in practice?

Sanov: Well, our hope is that people in this subgroup (that is, only about 5% to 10% of people with rectal cancer) will continue to have 6 months of immunotherapy and which of the rest of this. I don’t even have-I don’t even know the words to use. A paradigm shift is often used, but it’s really absolutely a paradigm shift.

Pfeiffer: I would like to emphasize that when we hear people kicked cancer, we often support people. However, the aftermath of their ability to deal with physical and side effects can still be life-changing. Therefore, the idea of ​​being able to skip surgery is very innovative.

Sanov: Yes. With rectal cancer, this is part of a conversation with someone when they are diagnosed-that is, we are very much hoping that we can cure you, but unfortunately our treatment is for you. In fact, it may change your life. That is, I have patients who have rarely left home for years, or even decades, after rectal cancer because of the consequences of incontinence and the associated shame.

Pfeiffer: Have you ever had a patient who said he regretted receiving treatment?

Sanov: That’s right.

Pfeiffer: Really?

Sanov: Yeah.

Pfeiffer: So what’s the next step if this drug is as good as it’s been seen in advance?

Sanov: What I really want is to use this drug in a much more diverse environment and take a larger test to understand what the actual true response rate will be. It can never be 100%. I’d love to say that in the future, but I don’t think it will be 100%. So, looking at the true response rate, that’s when I think we can always do this.

Pfeiffer: It’s Dr. Hannah Sanov of the Rheinberger Comprehensive Cancer Center at the University of North Carolina. Thank you very much.

Sanov: Thank you.

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