A patient of Indian origin was among those who had a “miraculous” cure using an anticancer drug being tested by a research center here, achieving an unprecedented cure rate when all 14 patients in the trial disappeared. “It’s a miracle,” Nisha Varughese said of the immunotherapy drug’s effectiveness in curing her.
However, the fight against this disease could soon evolve thanks to a promising new treatment tested in New York. Tested on 18 people, this treatment showed a cure rate of 100%, according to a study published in theNew England Journal of Medicine. “This is the first time this has happened in the history of cancers,” says Dr. Luis A. Diaz Jr, who worked on this study.
The drug used in the trials is called dostarlimab. It is made up of molecules created in the laboratory that act like antibodies in our bodies. Basically, doctors wanted to use it before patients had to go through more restrictive treatments such as chemotherapy or particularly invasive surgeries. Except that the treatment was so effective that no other operation was necessary for the patients afterwards because all traces of cancer had disappeared from their bodies during the various tests carried out. During the months following treatment, no recurrence was detected in patients who were followed up between 6 and 25 months.
Cancer treatment will be tested in patients
As Dr. Luis A. Diaz Jr explains, the patients treated all presented with a tumour with a genetic specificity called MMRd (mismatch repair-deficient) or MSI (microsatellite instability). This type of tumour affects between 5% and 10% of people affected by colorectal cancer and is less sensitive to chemotherapy and radiotherapy.
With this new treatment, doctors hope to enable some patients to continue living normal lives, which is sometimes impossible due to certain treatments that can cause nerve damage, infertility, and even bowel and sexual dysfunction. The treatment will also be tested in patients affected by other cancers, including prostate and pancreatic, which may be caused by this specific tumour. Further studies should, however, confirm the results of the study.
After at least six months of follow-up, all 12 patients showed a “complete clinical response” with no signs of the tumour.
“These results are cause for great optimism, but these are early days for the trial, as well as for patients who wish to embark on this treatment. This approach cannot supplant the current curative multimodal treatment approach,” said Dr. Nikhil S Ghadyalpatil, Principal Consultant. , Medical Oncologist and Hemato-Oncologist at Yashoda Hospitals in Hyderabad.
“Complete clinical response as the endpoint used in this study is an imperfect surrogate for a long-term cure and therefore should be interpreted with caution. We need larger placebo-controlled studies with longer follow-up in this setting to confidently consider using this approach in routine practice, Ghadyalpatil told PTI.
The treatment, the oncologist said, surely provides early insight into a revolutionary approach in rectal cancer patients and the authors of this study are to be congratulated for this effort. There have been no similar trials in India so far, he added. “Another similar international study with the drug pembrolizumab showed that only 70 per cent of patients had a long-term response at three years, as opposed to 100 per cent response in the current study,” he added.
Ghadyalpatil said that pembrolizumab is available in India, but the dostarlimab used in the current study is not. “The cost of dostarlimab is not known in India, but it is expected to be a couple of lakhs per dose,” he added.
Commenting on the trial, Dr. Hannah K. Sanoff of North Carolina Cancer Hospital said the results are optimistic but the treatment procedure used in the study cannot replace the current curative treatment approach.
“Patients who have a complete clinical response after chemotherapy and radiation therapy have a better prognosis than those who do not have a complete clinical response, however, cancer grows back in 20 to 30 per cent of those patients when the cancer is treated without surgery,” he said. she wrote in an editorial about the trial.
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