Hannah K., of the UNC Lineberger Comprehensive Cancer Center. Sanoff, MD, MPH, is the author of An Approach in New England Journal of Medicine Which provides a perspective on the evolving treatment of rectal cancer. She offers prospects for future treatments of the disease in light of encouraging findings from a study published in the journal Dostarlimab, which found that the immunotherapy drug dostarlimab specifically worked in a phase II clinical study of a dozen patients with a subtype of rectal cancer. was effective in testing.
Approximately 5–10% of rectal cancers are identified to be deficient in the molecularly mismatch repair enzyme (dMMR). These cancers are less responsive to chemotherapy and radiation, which increases the likelihood that surgical treatment is necessary. Unfortunately, surgery can result in notable health consequences, including nerve damage, infertility, and bowel and sexual dysfunction.
“More than 45,000 people were diagnosed with rectal cancer last year in the United States, and many of those cases were in people under the age of 65. Historic treatments for the disease have included radiation, surgery, and chemotherapy. The potential, despite being curative, can be debilitating, pointing to the need for better and more effective treatments that can increase longevity while maintaining quality of life,” said Sanoff, who heads the North Carolina Cancer Hospital. and innovation officer and professor in the UNC School of Medicine’s Division of Oncology. , “These preliminary findings of remarkable benefit with the use of dostarlimab are very encouraging, but should be viewed with caution until the results can be replicated in a larger and more diverse population.”
Sanoff also cautioned that little is known about how long the drug’s benefits will last or whether it will be curative in the long term. Patients in this trial have been seen for only six months to two years so far.
“Responses in the first 12 of these planned for the 30 patients in the trial were remarkable and exceed what we would expect with standard chemotherapy plus radiation,” Sanoff said. “Although measures of quality of life have not yet been reported, it is encouraging that some of the most difficult symptoms, such as pain and bleeding, all resolved with the use of dostarlimab.”
Sanoff notes that there are other immunotherapy drugs that may be tested against this type of rectal cancer as well. “As a gastrointestinal medical oncologist, I can think of nothing better than to be able to offer my patients a drug that makes them more effective, less toxic and saves them from surgery, chemotherapy, and radiation; that day may soon be over.” Can’t come,” she said.
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