This invention could very well be termed the ‘drug of the century’ as it is being claimed that every single rectal cancer patient, during a small clinical trial conducted by Manhattan’s Memorial Sloan Kettering Cancer Center in New York City, had their cancer go into remission after using a certain drug. The said patients underwent an experimental immunotherapy treatment during the trial. Doctors and health experts were shocked to observe the success.
The medication or drug that was experimentally given to the patients is called dostarlimab and is sold under the brand name Jemperli which costs $11,000 (approx Rs 8.5 lakh) per dose. Astonishingly, Dostarlimab is not a new find in the medicine world. It is an immunotherapy drug that was being used in the treatment of endometrial cancer. This was the first clinical investigation of whether the drug was effective against rectal cancer tumors or not and it worked!
The Cancer Research Findings
The findings were published on Sunday in the New England Journal of Medicine and featured at the nation’s largest gathering of clinical oncologists in June 2022. A total of 14 patients completed the treatment with Dostarlimab and underwent at least 6 months of follow-up.
“All 12 patients (100%; 95% confidence interval, 74 to 100) had a clinical complete response, with no evidence of tumor on magnetic resonance imaging,” the study stated.
All of the patients had rectal cancer in a locally advanced stage, along with a rare mutation called Mismatch Repair Deficiency (MMRd).
Subsequently, the cancer not only vanished in every single one of the patients who were a part of this experiment but remained undetectable by physical exam, endoscopy, PET scans or MRI scans.
“I believe this is the first time this has happened in the history of cancer,” quoted Medical oncologist Luis Diaz Jr. from Memorial Sloan Kettering Cancer Center (MSK), who is also the senior author of the new study reporting the results.
“It’s incredibly rewarding,” says Dr. Cercek, “to get these happy tears and happy emails from the patients in this study who finish treatment and realize, ‘Oh my God, I get to keep all my normal body functions that I feared I might lose to radiation or surgery.’ ”
Drs. Cercek and Diaz explain that their team’s research was sparked by two key ideas.
The first premise, says Dr. Diaz, is to figure out precisely which patients benefit most from immunotherapy, so they can receive it right away. “Immunotherapy has proven successful in treating a subset of patients with colon and rectal cancer that has metastasized, meaning spread to other tissues.”
The patients in this subset, Dr. Diaz explains, have tumors with a specific genetic makeup known as mismatch repair-deficient (MMRd) or microsatellite instability (MSI).
Between 5% and 10% of all rectal cancer patients are thought to have MMRd tumors, including all the patients in the MSK clinical trial that Sascha participated in. There are 45,000 Americans diagnosed a year with rectal cancer.
“An MMRd tumor develops a defect in its ability to repair certain types of mutations that occur in cells. When those mutations accumulate in the tumor, they stimulate the immune system, which attacks the mutation-ridden cancer cells,” says Dr. Diaz, who heads the MSK division of Solid Tumor Oncology and holds the Grayer Family Chair.
But cancer has a trick up its sleeve to stop the immune system from doing its job.
Usually, patients with rectal tumors are expected to undergo chemotherapy and radiation therapy prior to surgical removal of cancer. While only a lucky few are able to experience complete recovery, for many patients, this gamut of treatments comes with long-lasting consequences that can last the rest of their life or take it.
They can suffer life-altering bowel, bladder dysfunction, incontinence, infertility, sexual dysfunction, and even more. The patients who enrolled in this trial were lucky to both the therapy procedures and their associated side effects.
About Memorial Sloan Kettering Cancer Center
Memorial Sloan Kettering Cancer Center was founded in 1884 as New York Cancer Hospital on Manhattan’s Upper West Side by a group that included John J. Astor and his wife, Charlotte.
According to US News & World Report, Memorial Sloan Kettering has ranked as one of the top two hospitals for cancer care in the country for more than 30 years and among the nation’s top pediatric hospitals for cancer care.
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