‘Astonishing’ result in drug trial: First time, cancer vanishes in every patient

It was a small trial, just 18 rectum cancer All the patients took the same medicine. But the result was amazing. The cancer disappeared in all patients and could not be detected by physical examination, endoscopy, PET or MRI scans.

Dr. Luis A. Diaz Jr., Memorial Sloan Kettering Cancer Center, author of a new paper published on Sunday England The Journal of Medicine, which explains the results sponsored by pharmaceutical company GlaxoSmithKline, said no other study had completely eliminated cancer in all patients.

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“I believe this is the first time this has happened in the history of cancer,” said Dr. Diaz.

Dr. Alan P. Benuk, a colorectal cancer specialist at the University of California, San Francisco, who was not involved in the study, also said he thought this was the first time.

He said complete remission in all patients was “unprecedented.”

These patients with colorectal cancer faced severe treatments such as chemotherapy, radiation therapy, and possibly life-changing surgery that could cause bowel, urine, and sexual dysfunction. Some people need an artificial anal bag.

They entered the study thinking that they would have to undergo those treatments because no one really expected their tumors to disappear when it was over.

But they were surprised. No further treatment was needed.

“There were many happy tears,” said Dr. Andrea Cercek, an oncology scholar at the Memorial Sloan Kettering Cancer Center and co-author of a paper presented Sunday at the American Society of Clinical Oncology’s annual meeting.

Another surprise is that Dr. Venook had no clinically significant complications in any of the patients.

On average, one in five patients have some side effects on a drug such as that taken by a patient called Dostarlimab, a known checkpoint inhibitor. The drug was given every 3 weeks for 6 months and cost about $ 11,000 per dose. It removes the mask of cancer cells and allows the immune system to identify and destroy them.

Most side effects are easy to manage, but 3% to 5% of patients taking checkpoint inhibitors have more serious complications and, in some cases, weakness, dysphagia, and chewing difficulties. increase.

The absence of significant side effects means that “we did not treat a sufficient number of patients, or for some reason, these cancers are completely different.”

In an editorial accompanying the paper, Dr. Hannah K. Sanov of the University of North Carolina’s Rheinberger Comprehensive Cancer Center, who was not involved in the study, called it “small but compelling.” .. However, she added that it was not clear if the patient had healed.

“Little is known about the time required to determine if a complete clinical response to Dosterlimab is equivalent to cure,” Dr. Sanov said.

Dr. Kimmie Ng, an expert in colorectal cancer at Harvard Medical School, said the results were “notable” and “unprecedented” but needed to be reproduced.

The inspiration for rectal cancer research came from a clinical trial led by Dr. Diaz in 2017, funded by pharmaceutical company Merck. Eighty-six people with metastatic cancer that developed in different parts of the body were involved. However, all cancers shared genetic mutations that prevented cells from repairing damage to their DNA. These mutations occur in 4 percent of all cancer patients.

Patients in that study took pembrolizumab, a checkpoint inhibitor from Merck, for up to two years. Tumors shrank or stabilized and lived longer in about one-third to one-half of patients. Tumors disappeared in 10% of study participants.

Therefore, Dr. Cercek and Dr. Diaz asked: What if the drug was used in the early stages of the disease before the cancer spread?

Tesaro, a small biotechnology company, has agreed to sponsor their research. Thesaro was acquired by GSK plc Smith Klein.

Their first patient was Sascha Roth, who was 38 years old in 2019.

She was scheduled to begin chemotherapy at Georgetown University after Bing was detected in the cancer, but a friend claimed she would first meet Dr. Philip Patty at Memorial Sloan Kettering. Dr. Patty told her she was almost certain that her cancer contained mutations that were unlikely to respond well to chemotherapy. Ross was eligible to participate in a clinical trial. If she had started her chemotherapy, she wouldn’t.

After the trial, Dr. Sersek informed her. “We saw your scan,” she said. “There is absolutely no cancer.” She didn’t need any further treatment.

“I talked to my family,” Ross said. “They didn’t believe me.” But two years later she still doesn’t