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'the first time this has happened in cancer': tumours disappear in every rectal cancer patient

despite the small sample size, the results of the drug trial are groundbreaking, offering hope also for the treatment of pancreatic, bladder and stomach cancer.

small rectal cancer trial destroyed tumours in every single patient
colorectal cancer is the third most common cancer type in canada, affecting nearly 27,000 people. getty
a small trial of a new experimental rectal cancer drug had results that are “unheard of” in the world of cancer treatment: every single patient saw their tumours disappear. “i don’t think anyone has seen this before, where every single patient has had the tumour disappear,” the study’s lead author dr. andrea cercek, an oncologist with memorial sloan kettering cancer center in new york, told the washington post.
another co-author, dr. luis diaz, told the new york times he believes “this is the first time this has happened in the history of cancer.”
nine doses of the drug, dostarlimab, was given intravenously to 14 patients with early-stage rectal cancer. it works as a “checkpoint inhibitor,” the guardian explains: it works to remove a shield-like protectant that cancer cells build around the tumour. with that shield removed, the cancer cells can be identified and destroyed by the body’s immune system.
after six months of treatment, the tumours were gone in every patient. not one of them had cancer cells that could be detected by biopsies, scans or other exams.

“all 14 patients? the odds are exceedingly low and really unheard of in oncology,” cercek told the washington post.

of course, 14 is a relatively low sample size. these 14 patients were all in early stages of their cancer, and the good results are still recent — tumours could potentially re-emerge later on. also, the patients also have another very specific factor in common: their tumours all had a specific mutation — mismatch repair-deficiency — which means that the dna repair system in their cells does not function normally.
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another surprisingly positive outcome is that none of the patients had significant side effects. checkpoint inhibitors can sometimes cause complications including muscle weakness and difficulty with chewing and swallowing. this could mean dostarlimab is different than other medications of its type, or that the sample size was too small to observe these negative reactions.
the positive results, of course, are a starting point: a lot more research must be done before the treatment is more widely available, but its potential is significant — not just in treating rectal cancer, but also in treating, for instance, pancreatic, bladder or stomach cancer in other people with a mismatch repair-deficiency.
colorectal cancer is the third most common cancer type in canada, affecting nearly 27,000 people. it’s slightly more common in men than women — 1 in 14 men will be diagnosed with colorectal cancer in their lifetime, as opposed to 1 in 18 women.
for more information and resources about rectal cancer, visit colorectal cancer canada.
 
maija kappler is a reporter and editor at healthing. you can reach her at mkappler@postmedia.com
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