Cancer Completely VANISHED!

The Clinical Trial with a 100 % Success Rate

A recent clinical study used Dostarlimab to treat locally advanced rectal cancer patients with mismatch repair deficiency (genetic mutation). The standard procedure in treating Rectal cancer involves neoadjuvant therapy, chemotherapy, chemoradiotherapy and surgery (1-3). These treatments can lead to life-altering long-term side effects, including bowel, urinary, sexual dysfunctions, and infertility. Patients with mismatch repair deficiency do not respond well to neoadjuvant chemotherapy (4-6) and need alternative options.

A small group of 12 participants were intravenously administered 500 mg of dostarlimab every three weeks for six months. The treatment was initially supposed to be followed up by radiotherapy and surgery (neoadjuvant process), but surprising results changed the action plan (7). All 12 patients completed treatment, at least 6 months of follow-up and had a clinical complete response, with no evidence of tumour (Figure 1).

Figure 1: Estimated percentages of viable tumor cells on pathological

examination before, during and follow‐up treatment (7).

The treatment was 100 % efficient in making the tumor completely disappear, meaning cancer became undetectable by physical exam, endoscopy, PET scans or M.R.I. scans in all 12 patients and stayed that way even after six months of follow-up. Figure 2 below shows the results of endoscopic evaluations, T2‐weighted MRI of the rectum, and 18F‐fluorodeoxyglucose–positron‐emission tomography (FDG‐PET) for one of the patients at baseline, at three months and six months. The patient had a complete response and a near‐complete response on T2‐weighted rectal MRI at three months and a complete clinical response at six months (7).

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Figure 2: Evolution of Endoscopic and Radiographic Response in Representative Patients Treated with Dostarlimab (7).

This study would have to be replicated, and with a larger sample study group, Dostarlimab could also be tested on other types of cancers with a more extended follow-up period. What could this mean for cancer patients? this treatment may minimise the need for extensive treatments like chemotherapy, radiotherapy and surgery. Patients will experience fewer long-term effects. For more information, you may access the report here: https://www.nejm.org/doi/full/10.1056/NEJMoa2201445

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References:

1. Cercek A, Goodman KA, Hajj C, et al. Neoadjuvant chemotherapy first, followed by chemoradiation and then surgery, in the management of locally advanced rectal cancer. J Natl Compr Canc Netw 2014; 12:513-9.

2. Chua YJ, Barbachano Y, Cunningham D, et al. Neoadjuvant capecitabine and oxaliplatin before chemoradiotherapy and total mesorectal excision in MRI-defined poor-risk rectal cancer: a phase 2 trial. Lancet Oncol 2010;11:241-8.

3. Fernández-Martos C, Pericay C, Aparicio J, et al. Phase II, randomized study of concomitant chemoradiotherapy followed by surgery and adjuvant capecitabine plus oxaliplatin (CAPOX) compared with induction CAPOX followed by concomitant chemoradiotherapy and surgery in magnetic resonance imagingdefined, locally advanced rectal cancer: Grupo cancer de recto 3 study. J Clin Oncol 2010;28:859-65.

4. Cercek A, Dos Santos Fernandes G, Roxburgh CS, et al. Mismatch repair-deficient rectal cancer and resistance to neoadjuvant chemotherapy. Clin Cancer Res 2020;26:3271-9.

5. Alex AK, Siqueira S, Coudry R, et al. Response to chemotherapy and prognosis in metastatic colorectal cancer with DNA deficient mismatch repair. Clin Colorectal Cancer 2017;16:228-39.

6. Alatise OI, Knapp GC, Sharma A, et al. Molecular and phenotypic profiling of colorectal cancer patients in West Africa reveals biological insights. Nat Commun 2021;12:6821.

7. Cercek A, Lumish M, Sinopoli J, Weiss J, Shia J, Lamendola-Essel M et al. PD-1 Blockade in Mismatch Repair–Deficient, Locally Advanced Rectal Cancer. New England Journal of Medicine. 2022.