Rectal cancer: 100% remission in patients in a clinical study who underwent a new treatment

The clinical trial of a drug against rectal cancer with 100% success is a real glimmer of hope for the patients. However, these results need to be replicated at a larger scale to be significant.

The tumor disappeared. This happy diagnosis was shared with each of the 12 participants in the clinical trial of dostarlimab for the treatment of rectal cancer. The study, published Sunday, June 5, in the New England Journal of Medicine, therefore has a 100% success rate. A rarity.

The American researchers at Memorial Sloan Kettering Cancer Center, who are behind this work, are themselves amazed by their results. “I believe this is the first time in the history of cancer,” said Dr. Luis A Diaz of the New York Times.

Colon cancer, which also includes the rectum, is the second most common type of cancer in women and the third most common in men, according to health insurance companies. In this study, the researchers specifically looked at one of their forms, which carries a genetic mutation called MMrD, or “mismatch repair deficiency.”

These tumors, seen in 5-10% of patients with rectal cancer, tend to be less responsive to chemotherapy and radiation therapy. Therefore, these scientists opted for immunotherapy with dostarlimab.

Essentially, it’s a drug that “doesn’t attack the cancer itself directly, but by getting a person’s immune system to do most of the work,” says Dr. Studie, but wrote the editorial accompanying the study’s publication .

A study “Source of great optimism”

Until now, this type of treatment has not really been “part of routine colorectal cancer care.” In this case, dostarlimab is mainly used to treat endometrial cancer (the lining that lines the inside of the womb, editor’s note). But the results of this new research “are a source of great optimism,” according to Dr. Sanoff.

Dostarlimab was administered to the 12 patients every three weeks for a period of six months. This treatment was originally supposed to be followed by standard chemotherapy and surgery, but six months after stopping the drug, the cancer was gone. Today, two years after the study, the participants have not relapsed, had surgery, or required chemotherapy or radiation therapy.

Without wanting to dampen the hopes raised by these amazing results, the researchers want to be careful. The study is quite convincing, but remains small with 12 participants. They also recommend not jumping to the conclusion that cancer has been finally eradicated.

Because dostarlimab has not previously been used to treat colorectal cancer, “we know very little about the time it takes to know if a full clinical response” to this drug “equates to a cure,” Hanna Sanoff chafed.

In this regard, she is supported by Dr. Kimmie NG, an expert in colorectal cancer at Harvard Medical School. He considers the conclusions of this study to be “remarkable” and “unprecedented”, but recalls that these results need to be reproduced to be truly significant. Enthusiasm is therefore allowed, but in moderation.

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