There were 18 rectal cancer patients who took the same drug.
The results were stunningly good. Every single patient had the cancer gone by the time they got a physical exam.
According to the author of the paper published in the New England Journal of Medicine, there were no other studies in which a treatment completely destroyed a cancer.
You can sign up for The Morning newsletter.
This is the first time in the history of cancer that this has occurred.
Alan P. Venook, a colorectal cancer specialist at the University of California, San Francisco, who was not involved with the study, thought it was the first of its kind.
He said that a complete remission in a patient is not heard of.
The rectal cancer patients had faced a lot of treatments, most likely life-changing surgery, that could result in a range of problems. They would need bags.
When the study was over, they thought they would have to have procedures to remove their tumors.
They were surprised that no further treatment was needed.
The paper was presented at the annual meeting of the American Society of Clinical Oncology.
None of the patients had significant problems.
One in five patients have an adverse reaction to drugs like dostarlimab. Every three weeks for six months, the medication was given. The immune system can destroy cancer cells.
While most adverse reactions are easily managed, as many as 3% to 5% of patients who take checkpoint inhibitors have more severe side effects that result in muscle weakness and difficulty swallowing.
The lack of side effects means that either they did not treat enough patients or they are just plain different.
The editorial accompanying the paper was written by Dr. Sanoff, who was not involved in the study. It is not known if the patients are cured.
Sanoff said that little is known about the duration of time needed to find out if a complete response to dostarlimab equates to cure.
The results were "remarkable" and "unprecedented" according to a colorectal cancer expert at Harvard Medical School.
The inspiration for the rectal cancer study came from a clinical trial. There were 86 people with cancer that originated in different parts of their body. The cancers all had the same genes that prevented cells from repairing damage. In 4% of cancer patients, there are these genes.
The patients in that trial took pembrolizumab for up to two years. About one-third to one-half of the patients had tumors shrink or stable. Ten percent of the trial's participants had tumors disappear.
If the drug were used earlier in the course of the disease, what would happen if the cancer came back?
They decided on a study of patients with rectal cancer that had spread to other parts of the body, but not to other organs. Some patients with the same genes that were affected in the trial weren't benefiting from the treatment. Their rectal tumors grew instead of being shrunk.
Such patients would be able to avoid radiation and surgery with the help of immunotherapy.
The companies were asked if they'd sponsor a small trial. They said the trial was too dangerous. Patients who could be cured with standard treatments would be given the drug. The cancer could grow beyond the point at which it could be cured if the researchers' proposal is adopted.
It is difficult to change the standard of care. The machines want to do the surgery.
The study was sponsored by a small firm. The company executives had forgotten about the small trial when Tesaro was bought by Glaxo.
The first patient was 38 years old. She first noticed some rectal bleeding in the new year, but it didn't bother her, she is a runner and works at a furniture store.
Her doctor said she was not expecting this.
The doctor made a call the next day. The tumor had been removed. He said it was definitely cancer.
She said she melted down.
She was going to start her treatment at Georgetown University, but a friend wanted her to see Dr. Philip Paty. She was told by Paty that her cancer was not likely to respond well to treatment. He was eligible to participate in the trial. She wouldn't have been if she had begun treatment.
After the trial ended, he was going to move to New York for radiation and possibly surgery. She had her ovaries removed and put under her ribs to preserve her fertility.
She was given the news after the trial.
She told them to look at their scans. There is no disease. She did not require any more treatment.
He told his family. They didn't think I was telling the truth.
She didn't have any cancer after two years.
The New York Times Company is owned by The New York Times.
All Rights Reserved © 2024
