When a person develops compact tumors in the stomach or esophagus or rectum, oncologists know how to deal with them. But treatments often come with serious impact on quality of life. This may include removing the stomach or bladder, a permanent colostomy bag, radiation that makes patients inform and last damage to chemotherapy.
Thus, a research team at Memorial Sloan Kettering Cancer Center, using a medicine from GSK pharmaceutical company, tried something different.
The researchers started with a group of 103 people. Test participants were between 2 to 3 % of patients with cancer with tumors who should respond to immunotherapy, a drug that overcome obstacles that prevent the immune system from attacking cancers.
But in clinical trials, immunotherapy is not supposed to replace standardized treatments. The researchers, led by Dr. Luis A. Diaz Jr. and Dr. Andrea Cercek, they decided to give Dostarlimab on its own.
The result was amazing and could bring hope to the limited group of patients who question these cancers.
In 49 of the patients who had rectal cancer, the tumors disappeared and, after five years, have not been repeated. Cancer have also disappeared for 35 of 54 patients with other cancers, including the stomach, esophagus, liver, endometrial, urinary tract and prostate.
Of the 103 patients, cancers are repeated only at five. Three received additional doses of immunotherapy and one, whose tumor is repeated in a lymph node, the lymph node had been removed. These four patients so far have no evidence of illness. The fifth patient had additional immunotherapy that made the tumor shrink.
Researchers reported their results on Sunday at the American Union’s annual meeting on cancer research and a document published in the New England Journal of Medicine.
The results, said Dr. Bert Vogelstein, oncologist at Johns Hopkins in Baltimore, are “pioneering”.
The previous phases of the development of the drug occurred in his workshop and watched his progress with surprise.
“Twenty or 30 years ago, the idea that you could get large volumes of many different organs and treat them without surgery would seem like science fiction,” he said. But, he added, the discovery did not begin full of researchers’ minds. Instead, he noted, it is based on 40 years of research “starting with very basic science”.
The reason why immunotherapy still had a possibility against these large tumors is because patients’ tumors had what is known as mismatch recovery mutations in their genes that prevented them from correcting DNA damage. As a result, these tumors are filled with unusual proteins that mark the immune system to destroy them. But the tumors put a shield that prevents the attacks of the immune system. Immunotherapy permeates the shield and allows the immune system to destroy tumors.
For patients such as the study, said Dr. Michael Overman, a gastrointestinal cancer expert at MD Anderson Cancer Center in Houston, the results show immunotherapy without chemotherapy, radiation therapies or surgery is so reasonable and so reasonable. “
But, for now, this may not be so easy. The drug costs about $ 11,000 per installment and patients need nine infusions for six months. In order to obtain insurance coverage, the drug must be included in the clinical guidelines, sets of recommendations for treatments produced by professional organizations.
It has been approved as a treatment for uterine cancers with mismatch repair mutations and is included in the clinical guidelines for the treatment of rectal cancer, based on a previous small study. But patients with other cancers may have trouble taking the drug, Dr. Diaz said. However, Memorial Sloan Kettering still recruits for its clinical trial, so that patients with repair mutations and meet the requirements for the study can take the drug without drugs.
For some patients, immunotherapy was miraculous. It may have side effects – the most common among patients in the study were fatigue, rash and itching. The rarest side effects included lung infections and encephalitis.
Amenia’s 71 -year -old Maureen Sideris discovered that he had cancer after trying to eat a hamburger.
“It wouldn’t go down,” he said. There was some kind of blockage. It turned out to be a volume in the situation of the stomach and the esophagus.
She went to Sloan Kettering in 2019. Her surgeon told her that she needed surgery, chemotherapy and radiation and that surgery would be difficult – you might need to get a bit of her stomach and move her esophagus
But its volume had a recovery mutation of mismatch, so it joined the clinical trial. The first infusion was on October 14 of the same year. By January, its volume had left. Ms Sideris has a side effect from treatment – she has to take medication now to improve the way her kidneys work. But he says it is worth paying this price to avoid the intense treatment that would be stored for it.
“It was a journey,” he said. But, he added, he argued that he had nothing to lose when he agreed to try immunotherapy.
“I still had surgery as a backup if it didn’t work,” he said.
