Health
Rectal tumors disappear in anticancer drug trials, but they are not a cure.
Experimental drugs that utilize the body’s immune system to fight cancer have completely removed the tumors of people with certain types of rectal cancer.
Key Point:
- Twelve people with certain types of rectal cancer lost their tumor after 6 months of new treatment
- This drug, called dosterlimab, makes cancer cells look like the immune system.
- Researchers and other scientists have emphasized that this is a promising result, but this is only the first step.
Researchers at the Memorial Sloan-Kettering Cancer Center in New York and Yale University have found that a six-month course of a drug called Dosterlimab eliminates all tumors in 12 patients.
Tumors did not recover during an average follow-up of 1 year.
The results were “great”, but still very preliminary, said Graham Newstead, a colorectal surgeon and medical director of intestinal cancer in Australia.
“This is great, so it definitely needs a bigger test, but we’re not there yet.”
Satish Warrier, a colorectal surgeon at Peter MacCallum Cancer Center, Alfred Health and Epworth Healthcare, also agreed.
“”It’s exciting. We clearly want patients to get the best results. It’s a cure.
The results of the study are New England Journal of Medicine..
and Ancillary editorialHannah Sanov, a gastrointestinal oncologist at the University of North Carolina, said the findings were “extremely optimistic,” but the drug would not yet be able to replace current therapies.
Adjusted for a subset of rectal cancer
Participants had to first check some boxes to be included in the survey.
First, Dr. Newstead said their tumors had to be stage 2 or stage 3.
“Stage 2 is a tumor that grows on the wall, and stage 3 passes through the wall to reach adjacent tissue or lymph glands.
“Therefore, these were moderately advanced cancers.”
Their tumors also had at least one gene mutation that prevented cells from finding and repairing DNA damage.
This “DNA mismatch repair deficiency” is found in about 5 percent of patients with rectal cancer, Dr. Warrior said.
They generally do not respond well to radiation or chemotherapy. That is, treatment often involves surgery to remove part or all of the rectum.
And this can cause long-term problems.
“”[By attaching the colon to the anal canal], You really want the colon to serve the purpose of the rectum. I explain that it is fairly intelligent in distinguishing between solids, liquids and gases.
Therefore, the purpose of the Memorial Sloan Kettering study was to reduce the need for surgery by shrinking the tumor as much as possible with drug treatment.
The drug they used, Doster Limab, was developed by GlaxoSmithKline. This is known as a “checkpoint inhibitor” and Current Treatments for Mismatch Repair Defect Endometrial Cancer..
It’s not cheap — each dose costs $ 11,000 ($ 15,500).
However, it works by “unmasking” the tumor. Cancer cells have many tricks that allow them to grow and spread while flying under the radar of the immune system.
Dosterlimab latches on proteins found only in rectal cancer cells and alerts the immune system to targets that need to be attacked.
Treatment included 9 intravenous doses at 3-week intervals. The idea was that after 6 months, the remaining tumors would be treated with chemotherapy, radiation therapy, and surgery.
But that didn’t happen. The tumor decreased and then disappeared.
“And it was in all the assessments like positron emission tomography, MRI, re-examination of their rectum and biopsy of what was left on the wall,” said Dr. Newstead.
The researchers also wrote that “no cases of progression or recurrence were reported during the follow-up period (range 6-25 months).”
What needs to happen now?
According to Dr. Warrior, one of the reasons the results of this study are “exciting” is that patients may be able to avoid not only surgery but also radiation therapy.
Along with 12 people who completed the Doster Rimab course, 4 more people By the time the study was created and published, it was in the middle of a treatment regimen.
This is “a very small sample,” Dr. Newstead said.
“Studies to give a definitive answer require a large number of patients, two cohorts, comparing the same number of men and women. One has a drug or cure and the other has. Is not …
“”[Plus] Compare them with a significant number of patients in stage 2 and another number of patients in stage 3 and enough time to know that there is no recurrence.
It’s important to note that most people with at least 95% of rectal cancers still need conventional treatment, Dr. Warrior said.
It is not yet known if the drug will affect other types of rectal cancer, or even people in diverse communities, Dr. Sanov wrote.
This is because the trillions of microbes that line the gut, the gut microbiota, can affect the effectiveness of immunotherapy.
Researchers envision that their research is still in its infancy and that dosterlimab will be tested in other localized tumors with DNA mismatch defects, such as pancreatic cancer, gastric cancer, and prostate cancer.
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Sources 2/ https://www.abc.net.au/news/health/2022-06-10/cancer-drug-immunotherapy-rectal-dostarlimab-treatment-remission/101142596 The mention sources can contact us to remove/changing this article |
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