A new trial could be small in sample size, but very big in progress against cancer. And it is that, the tests carried out with the drug dostarlimab, a monoclonal antibody that blocks the receptor of the programmed cell death protein 1 (PD-1), have resulted in the complete remission of advanced rectal cancer in all the patients who participated in the study (12). “I think this is the first time this has happened in the history of cancer,” said Luis A. Diaz Jr., a physician at Memorial Sloan Kettering Cancer Center, who authored the paper.
What is striking about this study is that it is the first to completely eradicate cancer with just one drug, that is, without the patient having to undergo other treatments such as radiation, chemotherapy or surgery. Until now, people with these types of tumors were receiving neoadjuvant chemotherapy and radiation, along with surgical removal of the rectum, as standard therapy.
As The New York Times pointed out, the study participants thought that at the end of it they would have to undergo this type of procedure because nobody expected their tumors to disappear, but they were pleasantly surprised: no other treatment was necessary. “There were a lot of happy tears,” recalled Andrea Cercek, an oncologist at Memorial Sloan Kettering Cancer Center and co-author of the paper.
All this could change if the results of this research, which has been carried out by members of the Memorial Sloan Kettering Cancer Center (USA) and published in The New Journal England of Medicine, are confirmed. In it, dostarlimab was administered to patients with stage II or III rectal adenocarcinoma with mismatch repair deficiency every three weeks for a period of six months.
The drug eradicates rectal cancer in just six months
Even the researchers were surprised to see the effects of this drug in patients after only six months of follow-up, because in all of them the cancer disappeared, which was not visible on physical examinations, nor on endoscopies, CT scans or magnetic resonance imaging performed.
After six months of treatment, dostarlimab managed to completely eliminate rectal cancer with no side effects or recurrence to date
The analyzed drug acts by unmasking cancer cells, which allows the immune system to better identify them and act more effectively against them. So much so, that in the trial carried out they managed to completely eliminate rectal cancer and so far they have not shown any symptoms of recurrence of the disease.
According to data from the Vall D’Hebron Hospital in Barcelona, dostarlimab is already being used in Europe to treat endometrial cancer, obtaining objective response rates of 43.5% and a disease control rate of 55.6%. . Therefore, if other larger studies reach these same conclusions, it is possible that this drug will be used for other types of cancer, although it has the great disadvantage that it costs no less than 11,000 dollars (10,200 euros) for each dose.
Regarding the side effects that its intake can cause, the researchers explain that on average one in five patients who take checkpoint inhibitor drugs – such as dostarlimab – usually have a serious adverse reaction, such as muscle weakness or difficulty chewing and swallow. However, no significant side effects were found in this trial, which could be because not enough people were treated or because these types of cancers respond differently to treatment.
Based on all this, the researchers believe that they have taken a very important step in the fight against cancer, but they are cautious and urge that larger studies continue to be carried out in order to corroborate these very promising results. If so, rectal cancer could have its days numbered.
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