The medical community is abuzz over the results of a small but extremely promising experimental drug trial in which all 12 rectal cancer patients achieved remission within six months. The trial was conducted by oncologists at the revered Memorial Sloan Kettering Cancer Center in New York City.
The New York Times reported Sunday that cancer had “vanished” in each case. It was “undetectable by physical exam, endoscopy, PET scans or M.R.I. scans,” the outlet said.
Following a presentation of the study’s findings at the annual meeting of the American Society of Clinical Oncology on Sunday, Dr. Luis A. Diaz Jr. published the results in The New England Journal of Medicine.
Diaz told the Times he wasn’t aware of any other study in which the treatment had completely obliterated cancer in every patient. “I believe this is the first time this has happened in the history of cancer,” he said.
The drug, dostarlimab, is sold under the brand name Jemperli. It was developed by the Massachusetts biotech company Tesaro and acquired by GlaxoSmithKline in 2019, according to WNBC-TV.
Jemperli, an immunotherapy drug, was approved by the FDA in April 2021 for the treatment of endometrial cancer.
The Times reported that it “unmasks cancer cells, allowing the immune system to identify and destroy them.”
Prior to this trial, patients diagnosed with rectal cancer ordinarily were offered extremely unpleasant treatment options such as “chemotherapy, radiation and, most likely, life-altering surgery that could result in bowel, urinary and sexual dysfunction. Some would need colostomy bags,” the report said.
If Jemperli is truly as effective as this trial seems to indicate, this is great news indeed.
The science of it is described in an article published Monday by Science Alert. The patients in this study, it said, “had tumors with genetic mutations called mismatch repair deficiency (MMRd), seen in a subset of approximately 5–10 percent of rectal cancer patients.”
“Patients with such tumors tend to be less responsive to chemotherapy and radiation treatments, which increases the need for surgical removal of their tumors,” the report said.
“However, MMRd mutations can also make cancer cells more vulnerable to immune response, especially it’s bolstered by an immunotherapy agent – in this case, a checkpoint inhibitor, which unleashes restrictions on immune cells so they can more effectively kill cancer cells.”
Diaz explained, “When those mutations accumulate in the tumor, they stimulate the immune system, which attacks the mutation-ridden cancer cells. We thought, ‘Let’s try it before cancer metastasizes as a first line of treatment.’”
Patients in this trial were administered doses of Jemperli every three weeks for a period of six months. Each dose costs $11,000, according to the Times.
Oncologist Hanna K. Sanoff from the University of North Carolina, Chapel Hill commented on this study in The New England Journal of Medicine. She wrote that these preliminary results should be regarded with both optimism and caution.
“Very little is known about the duration of time needed to find out whether a clinical complete response to dostarlimab equates to cure. … Whether the results of this small study conducted at Memorial Sloan Kettering Cancer Center will be generalizable to a broader population of patients with rectal cancer is also not known,” Sanoff said, according to Science Alert.
“Despite these uncertainties,” she wrote, “[MSK medical oncologist and study co-author Andrea] Cercek and colleagues and their patients who agreed to forgo standard treatment for a promising but unknown future with immunotherapy have provided what may be an early glimpse of a revolutionary treatment shift.”
Immunotherapy is a relatively new tool for oncologists. Considered by many to be used as a “last resort,” its rate of success has varied widely.
It appears to have worked for an elderly friend of mine whose melanoma had metastasized to his lungs.
At the outset, his oncologist said that two years earlier, he would have told him to go home and get his affairs in order, but that recent advances in immunotherapy treatment had been promising.
The early findings of the Memorial Sloan Kettering trial are nothing short of amazing. Scientists could be on the cusp of a serious breakthrough in the fight against cancer.
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