Immunotherapy drugs can help cancer patients avoid terrifying surgeries and harsh treatments

When a person develops solid tumors in the stomach, esophagus or rectum, oncologists know how to treat them. However, treatments often have a serious impact on quality of life. This includes removal of the stomach and bladder, permanent colostomy layer bags, radiation, infertility caused by chemotherapy, and permanent damage.

So, a research group at the Memorial Sloan Kettering Cancer Center, which used drugs from pharmaceutical company GSK, tried something different.

The researchers started with a group of 103 people. The trial participants are one of 2-3% of cancer patients with tumors that have tumors that should respond to immunotherapy, and are drugs that overcome barriers that prevent the immune system from attacking cancer.

However, clinical trials do not assume that immunotherapy will be replaced by standard treatment. Researchers led by Dr. Lewis A. Diaz Jr. and Andrea Cerseck decided to give supplyin itself an immunotherapeutic drug.

The results were surprising and were able to provide hope for a limited cohort of patients competing for these cancers.

In 49 patients with rectal cancer, the tumor disappeared and did not recur after 5 years. Of the 54 patients suffering from other cancers, including cancer, esophagus, liver, endometrium, urinary tract, and prostate, 35 have disappeared.

Of all 103 patients, only five had cancer recurrence. Three doses of immunotherapy were added, one was removed as the tumor recurred in the lymph nodes. So far, these four patients have no evidence of the disease. The fifth patient received additional immunotherapy that would contract the tumor.

Investigators on Sunday said the American Cancer Research Association's Annual Meeting paper Featured in the New England Journal of Medicine.

The result was “groundbreaking” oncologist Dr. Bert Vogelstein, at Johns Hopkins in Baltimore.

The early stages of drug development took place in his lab, and he saw the advancement with surprise.

“The idea that you can take large tumors from many different organs 20 or 30 years ago and treat them without surgery seems like science fiction,” he said. However, he added that the discoveries were not fully imbued into the minds of researchers. Instead, he points out that he is based on 40 years of research, “starting with very basic science.”

The reason immunotherapy had a chance for these large tumors is that the patient's tumors had what is known as gene incompatible repair mutations, preventing the correction of DNA damage. As a result, such tumors are studded with abnormal proteins that the immune system indicates to destroy them. However, the tumor has raised the shield that blocks immune system attacks. Immunotherapy stimulates the shield and allows the immune system to destroy tumors.

For patients like this study, Dr. Michael Oberman, a gastrointestinal cancer expert at the MD Anderson Cancer Center in Houston, says the results indicate chemotherapy, radiation therapy, or surgery-free immunotherapy.

But for now, that may not be that easy. The drug costs around $11,000 per dose, and patients require nine infusions in six months. To obtain insurance coverage, the drug should be included in clinical guidelines, a set of recommendations for treatments produced by professional organizations.

It has been approved as a treatment for uterine cancer with mismatch repair mutations and is included in clinical guidelines for the treatment of rectal cancer based on previous miniaturization study. However, other cancer patients may have problems taking medication, Dr. Diaz said. However, Memorial Sloan Kettering is still recruiting for clinical trials, so repair mutations are inconsistent and patients with tumors eligible for the study can make the drug free.

For some patients, immunotherapy is miraculous. Side effects may occur. The most common in this study were fatigue, rashes and itching. More rare side effects include pulmonary infections and encephalitis.

Maureen Sidris, 71, of Amenia, New York, learns that she has cancer after trying to eat a burger.

“That won't go down,” she said. There was some kind of blockage. It turns out to be a tumor at the junction of her stomach and esophagus.

She went to Sloan Kettering in 2019. Her surgeon said surgery, chemotherapy and radiation therapy were required and surgery was difficult.

However, her tumor had a mismatch repair mutation, which led her to participate in a clinical trial. The first injection was on October 14th of that year. By January, her tumor was gone. Sidelis has a one-sided effect from treatment. She now needs to take medication to improve her kidney function. However, she says it's worth paying that price to avoid the troublesome treatment that would have been available for her.

“It was a journey,” she said. However, she added that she reasoned that she had nothing to lose when she agreed to try immunotherapy.

“If things didn't work, I still had surgery as a backup,” she said.