A ray of hope? Cancer Disappeared Unanticipatedly in Every Patients

Today one news that is breaking on the internet. A small drug trial conducted in MSKCC, US observed every patient in the study had their cancer successfully go into complete remission. Despite the fact that the study is modest, it provides a glimpse of hope to those who are suffering from this fatal disease.

A total of 12 patients with rectal cancer showed positive results against the drug called dostarlimab, sold under the brand name Jemperli. A subset of rectal cancer is caused by a deficiency in mismatch repair (MMRd). Mismatch repair deficient tumors are sensitive to checkpoints inhibitors (PD-1), it was hypothesized that PD-1 blockade could be worthwhile in patients with locally advanced rectal cancer. Patients with such malignancies are anticipated to have chemotherapy and radiation therapy before having the tumor surgically removed.

For most patients this series of treatments that could result in life-altering bowel, bladder, and urinary dysfunction, incontinence, infertility, and more.

Dostarlimab, an anti-PD-1 monoclonal antibody manufactured by GSK, is an immunotherapy used for the treatment of endometrial cancer and was approved for medicinal use in the US and EU on April'21.

Patients (median age,54 years; 67% women; 61% white) with mismatch repair-deficient stage II and III rectal adenocarcinoma received dostarlimab Q3W for 6 months. The treatment was to be followed by standard CRT and surgery. Although, those who showed complete response to treatment could omit CRT and surgery. A total of 12 patients have completed treatment with dostarlimab with at least 6 months of follow-up. All patients had a clinical complete response (100%; 95% CI, 74 to 100), with no sign of tumor on biopsy, digital rectal exam, endoscopic visualization, fluorodeoxyglucose-PET, or MRI

At the time of this report, no patients had received CRT or surgery. Moreover, no cases of progression had been reported during follow-up. Although, about three-quarters of patients have experienced mild side effects like rash, itching, fatigue, and nausea. Reports suggested that 3 to 5% of patients who take checkpoint inhibitors have more severe complications, in some cases, resulting in muscle weakness and difficulty in chewing and swallowing. The results are positive and encouraging but the duration of time needed to find out whether a complete clinical response to dostarlimab equates to a cure is still undiscovered. In addition to that, clinical complete response to the treatment is not a replacement for long-term cancer controls, also cancer regrowth is usually expected to still occur.

Eventually, the trial is expected to include 30 patients to collect more data on dostarlimab and to check how safe and effective it is in patients with rectal cancer. The study will be continued in the patient population. Apart from that, studies are ongoing on the microenvironment in the samples collected in this trial to determine the powerful response. Plus, a study of PD-1 blockades in all microsatellite instability solid early-stage tumors, such as gastric cancer, pancreas cancer, and bladder cancer is still in progress.

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