Small trial sees potential for new drug for rectal cancer | science | In-depth reports on science and technology | DW

After receiving an experimental drug called dostarlimab in a small trial, all 12 participants experienced complete remission. Doctors say this is the first time this cancer drug has achieved a 100% success rate in a clinical trial.

The results of the small study, conducted by researchers at Memorial Sloan Kettering Cancer Center in New York, were published in the New England Journal of Medicine. The trial results were funded by the pharmaceutical company GlaxoSmithKline.

Cancer patients receive the drug intravenously every three weeks for six months.

Side effects of rectal cancer treatment

The study says none of the patients experienced a recurrence of their disease or required further treatment over the course of the follow-up period, which lasted about a year on average.

In addition, none of the 12 patients experienced serious side effects, which are one of the main problems with typical rectal cancer treatments.

In general, the rare form of rectal cancer tested in the trial did not respond well to chemotherapy, which can have life-altering effects on a person’s health.

Although some developed a rash, skin inflammation, fatigue, itching, or nausea, none experienced a more serious complication common with rectal cancer treatments — side effects such as infertility, neuropathy, or impotence.

Colorectal cancer refers to colorectal cancer

Both colorectal cancers are often grouped together as “colorectal cancer,” a group that represents the third most common form of cancer in the world. But they are not the same thing.

Colon cancer describes the presence of cancer cells in the colon, while rectal cancer describes rectal cancer.

Rectal cancer is less common than colon cancer and is more difficult to treat. Common symptoms include rectal bleeding, constipation, and abdominal pain.

The cure rate is high if the disease is caught early.

When rectal cancer is localized, the five-year survival rate is 90%. If it spreads a little, the rate drops to 73%, and if it spreads a lot, the rate drops to 17%.

Each patient in this recent study had a very specific form of rectal cancer called mismatch repair imperfect rectal adenocarcinoma.

This type of cancer is more difficult to treat than general rectal cancer.

Mismatch repair – imperfective rectal cancer is relatively uncommon – affects only 5-10% of rectal cancer patients and does not respond well to chemotherapy.

colon cancer chart

Colorectal cancer is an umbrella term for two types of cancer that are similar, but not the same. Both have a good prognosis if caught early.

How important is the trial of dostarlimab for the treatment of cancer?

Dostarlimab is not a new drug – it has been used to treat endometrial cancer.

The drug is known as a “checkpoint inhibitor,” which means that instead of completely killing cancer cells, it allows a person’s immune system to kill the cells on its own — and is therefore considered an immunotherapy.

The results are “a cause for great optimism,” according to Hana Sanoff in an editorial published in the same journal in which the study findings appeared. Sanoff is a cancer physician and professor at the University of North Carolina at Chapel Hill. Did not participate in the search.

Sanoff writes that the drug cannot be used as a substitute for any current treatment for this or any other form of cancer.

Sanoff wrote that patients in the trial experienced what doctors call a “complete clinical response” and had a better prognosis than those without a complete clinical response, but could still see cancer growth in years to come.

“Very little is known about the length of time needed to know whether a complete clinical response to dostarlimb is equivalent to treatment,” Sanoff wrote.

Someone giving someone a prescription for medicine

It will take time to understand how widely immunotherapy can be used to treat various forms of cancer, but doctors and researchers hope

Too early to call it a cancer treatment

Sanoff notes that it’s also unclear whether the trial results will be applicable to a general group of rectal cancer patients, given the fact that all patients have a particularly rare form of the disease.

The study authors also note the need to test the drug in more people before they can draw any conclusions about its potential superiority over chemotherapy for rectal cancer.

“The study is small and represents the experience of a single institution,” the authors wrote in their paper, adding that the results would need to be reproduced in a larger, more racially and ethnically diverse group before any decisions can be made about a potential treatment.

Sanoff writes that, in light of the caveats, the research offers only “what may be an early glimpse into a revolutionary therapeutic shift.”

Editing: Zulfiqar Abani

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