Experimental cancer drug trial shows ‘proof of principle’ that could help treat other tumors

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After research on small cancer treatments Unprecedented result that 100% of participants went into remissionOncologists, and patients wonder if the approach from experimental drug trials can be applied to other types of cancer.

The study From the Memorial Sloan-Kettering Cancer Center in New York, oncologists are excited about the prospect that the treatment type used in the study, immunotherapy, will be more and more effective without surgery for tumors with certain abnormalities. doing. All participants in the study had a tumor with an abnormality known as mismatch repair (MMR) deficiency. It is a mutation that occurs in 5-10% of cases of rectal cancer and is also present in tumors of the endometrium, bladder, breast, and prostate.

This study was tested in patients with tumor mutations in about 4% of all cancer cases, but the results show that certain tumors tend to be more resistant to traditional tumors due to the mutation. Provides a template for how to adjust immunotherapeutic agents to attack. Treatment according to Julie Gralow, Chief Medical Officer and Executive Vice President of the American Society of Clinical Oncology.

“It’s a promise of this: it’s the concept that the genomics of what really moves it and what’s moving it can be therapeutically matched,” Gralow told The Washington Post Thursday. “This is because we can go beyond this subset of rectal cancer.”

The Sloan Kettering trial, which began in late 2019, enrolled 18 patients with early-stage rectal cancer with the same tumor mutation who had not received prior treatment and received Dostar Limab every 3 weeks for 6 months. Tumors had completely disappeared (and 4 were on track with similar results) in all 14 patients who had completed treatment by the time the study was published, and none required follow-up treatment. ..

This result is the first time that immunotherapy alone has eliminated the need for chemotherapy, radiation therapy, or surgery, and although patients can be treated, infertility, bowel and sexual dysfunction, artificial It leaves a life-changing effect such as a permanent reliance on the anal bag.

The authors of the study note that the earliest patients to complete the study are at least 2 years after treatment and that all patients are monitored for at least 5 years to ensure that there is no tumor regrowth or recurrence. increase.

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Scott Copetz, a professor of gastrointestinal oncology at the MD Anderson Cancer Center in Houston, calls the study “a solid advance in the field” and how immunotherapy can be used to treat MMR-deficient tumors. He explained that it has been used as “absolutely groundbreaking”.

“The idea of ​​using immunotherapy for patients with localized early colorectal cancer is certainly gaining momentum,” he said. New research provides the recognition that “if the immune system can be properly involved … those cancers can be eradicated.”

Even advanced-stage cancers show susceptibility to drugs such as those used in the study. Known as a “checkpoint inhibitor,” the drug blocks certain cancer cell proteins and may help the immune system suppress the response to the fight against cancer, rather than identifying and eradicating it. I have. Cancer rarely relapses after several years of eradication, Kopetz said.

Data from other studies show that 70% of people with metastatic colorectal tumors treated with immunotherapeutic agents are cancer-free after 5 years, he said, treating terrible illnesses. Great progress. Metastatic cancer is even more difficult to treat than tumors that are confined to the rectum or colon.

Small-scale anticancer drug trials have confirmed that tumors disappear in 100% of patients

Attention should be paid to this study. Copetz et al. Warned that six months was not enough to know if a patient could remain cancer-free forever. He said these medicines often need to be taken for a year or two before patients can leave them and continue to be confident that their cancer has been eliminated. .. However, unlike chemotherapy and radiation therapy, the drug is usually well tolerated during that period.

Perhaps more importantly, the genetic defects in the tumors of these patients make the drug much more effective, but other forms of cancer are much more common than colon and endometrial cancers. Not. Therefore, people with lung or brain tumors who do not have that defect are far less likely to have this type of cure, Copetz said.

David Ryan, Dean of the Department of Clinical Oncology at Massachusetts General Hospital, said that although the treatments used in the study may become more widely available, everyone who can receive treatment is available to the study participants. Intervene if the tumor recurs.

“I’m worried that if a recurrence occurs, I’ll have to pick them up as soon as possible to give people the best chance,” Ryan said.

The study confirms that the future of cancer treatment is a narrower approach based on cancer type, such as tailored planning to address specific features of the tumor, said Gralow of ASCO.

“I’m excited to see such a dramatic reaction,” she said of the test results. “I hope we can see such a dramatic match for other cancers.”

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