{"id":38471,"date":"2022-06-06T04:54:06","date_gmt":"2022-06-06T04:54:06","guid":{"rendered":"https:\/\/harchi90.com\/small-study-on-rectal-cancer-results-in-remission-in-every-patient\/"},"modified":"2022-06-06T04:54:06","modified_gmt":"2022-06-06T04:54:06","slug":"small-study-on-rectal-cancer-results-in-remission-in-every-patient","status":"publish","type":"post","link":"https:\/\/harchi90.com\/small-study-on-rectal-cancer-results-in-remission-in-every-patient\/","title":{"rendered":"Small Study on Rectal Cancer Results in Remission in Every Patient"},"content":{"rendered":"<div>\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\">It was a small trial, just 18 rectal cancer patients, every one of whom took the same drug.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">But the results were astonishing.  The cancer vanished in every single patient, undetectable by physical exam, endoscopy, PET scans or MRI scans.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">Dr. Luis A. Diaz Jr. of Memorial Sloan Kettering Cancer Center, an author of a paper published Sunday in the New England Journal of Medicine describing the results, which were sponsored by the drug company GlaxoSmithKline, said he knew of no other study in which a treatment completely obliterated a cancer in every patient.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">\u201cI believe this is the first time this has happened in the history of cancer,\u201d Dr. Diaz said.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">Dr. Alan P. Venook, a colorectal cancer specialist at the University of California, San Francisco, who was not involved with the study, said he also thought this was a first.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">A complete remission in every single patient is \u201cunheard-of,\u201d he said.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">These rectal cancer patients had faced grueling treatments &#8211; chemotherapy, radiation and, most likely, life-altering surgery that could result in bowel, urinary and sexual dysfunction.  Some would need colostomy bags.<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"\/><\/div>\n<div>\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\">They entered the study thinking that, when it was over, they would have to undergo those procedures because no one really expected their tumors to disappear.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">But they got a surprise: No further treatment was necessary.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">\u201cThere were a lot of happy tears,\u201d said Dr. Andrea Cercek, an oncologist at Memorial Sloan Kettering Cancer Center and a co-author of the paper, which was presented Sunday at the annual meeting of the American Society of Clinical Oncology.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">Another surprise, Dr. Venook added, was that none of the patients had clinically significant complications.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">On average, one in five patients have some sort of adverse reaction to drugs like the one the patients took, dostarlimab, known as checkpoint inhibitors.  The medication was given every three weeks for six months and cost about $ 11,000 per dose.  It unmasks cancer cells, allowing the immune system to identify and destroy them.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">While most adverse reactions are easily managed, as many as 3 percent to 5 percent of patients who take checkpoint inhibitors have more severe complications that, in some cases, result in muscle weakness and difficulty swallowing and chewing.<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"\/><\/div>\n<div>\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\">The absence of significant side effects, Dr. Venook said, means &#8220;either they did not treat enough patients or, somehow, these cancers are just plain different.&#8221;<\/p>\n<p class=\"css-at9mc1 evys1bk0\">In an editorial accompanying the paper, Dr. Hanna K. Sanoff of the University of North Carolina&#8217;s Lineberger Comprehensive Cancer Center, who was not involved in the study, called it &#8220;small but compelling.&#8221;  She added, though, that it is not clear if the patients are cured.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">\u201cVery little is known about the duration of time needed to find out whether a clinical complete response to dostarlimab equates to cure,\u201d Dr. Sanoff said in the editorial.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">Dr. Kimmie Ng, a colorectal cancer expert at Harvard Medical School, said that while the results were \u201cremarkable\u201d and \u201cunprecedented,\u201d they would need to be replicated.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">The inspiration for the rectal cancer study came from a clinical trial Dr. Diaz led in 2017 that Merck, the drugmaker, funded.  It involved 86 people with metastatic cancer that originated in various parts of their bodies.  But the cancers all shared a gene mutation that prevented cells from repairing damage to DNA.  These mutations occur in 4 percent of all cancer patients.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">Patients in that trial took a Merck checkpoint inhibitor, pembrolizumab, for up to two years.  Tumors shrank or stabilized in about one-third to one-half of the patients, and they lived longer.  Tumors vanished in 10 percent of the trial&#8217;s participants.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">That led Dr. Cercek and Dr. Diaz to ask: What would happen if the drug were used much earlier in the course of disease, before the cancer had a chance to spread?<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"\/><\/div>\n<div>\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\">They settled on a study of patients with locally advanced rectal cancer &#8211; tumors that had spread in the rectum and sometimes to the lymph nodes but not to other organs.  Dr. Cercek had noticed that chemotherapy was not helping a portion of patients who had the same mutations that affected the patients in the 2017 trial.  Instead of shrinking during treatment, their rectal tumors grew.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">Perhaps, Dr. Cercek and Dr. Diaz reasoned, immunotherapy with a checkpoint inhibitor would allow such patients to avoid chemotherapy, radiation and surgery.<\/p>\n<section role=\"complementary\" class=\"css-1iixf4w\" aria-label=\"New Developments in\u00a0Cancer Research\">\n<h2 class=\"css-ba3d02\">New Developments in Cancer Research<\/h2>\n<hr\/>\n<div id=\"storyline-context-container\" aria-live=\"polite\" aria-atomic=\"true\"><span class=\"css-1ly73wi e1tej78p0\">Card 1 of 6<\/span><\/p>\n<div data-scrolled-index=\"0\" class=\"swiper css-1goft0b\">\n<div class=\"css-1vt1os1\" aria-hidden=\"false\">\n<div class=\"css-1novq15\" data-testid=\"context-card\">\n<p class=\"itemClass\"><strong>Progress in the field.<!-- --> <\/strong><span>In recent years, advancements in research have changed the way cancer is treated.  Here are some recent updates:<\/span><\/p>\n<\/div>\n<\/div>\n<div class=\"css-1vt1os1\" aria-hidden=\"true\">\n<div class=\"css-1novq15\" data-testid=\"context-card\">\n<p class=\"itemClass\"><strong>Pancreatic cancer.<!-- --> <\/strong><span>Researchers managed to tame advanced pancreatic cancer in a woman by genetically reprogramming her T cells, a type of white blood cell of the immune system, so they can recognize and kill cancer cells.  Another patient who received the same treatment did not survive.<\/span><\/p>\n<\/div>\n<\/div>\n<div class=\"css-1vt1os1\" aria-hidden=\"true\">\n<div class=\"css-1novq15\" data-testid=\"context-card\">\n<p class=\"itemClass\"><strong>Chemotherapy.<!-- --> <\/strong><span>A quiet revolution is underway in the field of cancer treatment: A growing number of patients, especially those with breast and lung cancers, are being spared the dreaded treatment in favor of other options.<\/span><\/p>\n<\/div>\n<\/div>\n<div class=\"css-1vt1os1\" aria-hidden=\"true\">\n<div class=\"css-1novq15\" data-testid=\"context-card\">\n<p class=\"itemClass\"><strong>Leukemia.<!-- --> <\/strong><span>After receiving a new treatment, called CAR T cell therapy, more than a decade ago, two patients with chronic lymphocytic leukemia saw the blood cancer vanish.  Their cases offer hope for those with the disease, and create some new mysteries.<\/span><\/p>\n<\/div>\n<\/div>\n<div class=\"css-1vt1os1\" aria-hidden=\"true\">\n<div class=\"css-1novq15\" data-testid=\"context-card\">\n<p class=\"itemClass\"><strong>Esophageal cancer.<!-- --> <\/strong><span>Nivolumab, a drug that unleashes the immune system, was found to extend survival times in patients with the disease who took part in a large clinical trial.  Esophageal cancer is the seventh most common cancer in the world.<\/span><\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/section>\n<p class=\"css-at9mc1 evys1bk0\">Dr. Diaz began asking companies that made checkpoint inhibitors if they would sponsor a small trial.  They turned him down, saying the trial was too risky.  He and Dr. Cercek wanted to give the drug to patients who could be cured with standard treatments.  What the researchers were proposing might end up allowing the cancers to grow beyond the point where they could be cured.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">\u201cIt is very hard to alter the standard of care,\u201d Dr. Diaz said.  &#8220;The whole standard-of-care machinery wants to do the surgery.&#8221;<\/p>\n<p class=\"css-at9mc1 evys1bk0\">Finally, a small biotechnology firm, Tesaro, agreed to sponsor the study.  Tesaro was bought by GlaxoSmithKline, and Dr. Diaz said he had to remind the larger company that they were doing the study &#8211; company executives had all but forgotten about the small trial.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">Their first patient was Sascha Roth, then 38. She first noticed some rectal bleeding in 2019 but otherwise felt fine &#8211; she is a runner and helps manage a family furniture store in Bethesda, Md.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">During a sigmoidoscopy, she recalled, her gastroenterologist said, \u201cOh no.  I was not<em class=\"css-2fg4z9 e1gzwzxm0\"> <\/em>expecting this! &#8220;<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"\/><\/div>\n<div>\n<div class=\"css-53u6y8\">\n<p class=\"css-at9mc1 evys1bk0\">The next day, the doctor called Ms. Roth.  He had had the tumor biopsied.  \u201cIt&#8217;s definitely cancer,\u201d he told her.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">\u201cI completely melted down,\u201d she said.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">Soon, she was scheduled to start chemotherapy at Georgetown University, but a friend had insisted she first see Dr. Philip Paty at Memorial Sloan Kettering.  Dr. Paty told her he was almost certain her cancer di lei included the mutation that made it unlikely to respond well to chemotherapy.  It turned out, though, that Ms. Roth was eligible to enter the clinical trial.  If she had started chemotherapy, she would not have been.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">Not expecting a complete response to dostarlimab, Ms. Roth had planned to move to New York for radiation, chemotherapy and possibly surgery after the trial ended.  To preserve her fertility after the expected radiation treatment, she had her ovaries removed and put back under her ribs.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">After the trial, Dr. Cercek gave her the news.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">\u201cWe looked at your scans,\u201d she said.  &#8220;There is absolutely no cancer.&#8221;  She did not need any further treatment.<\/p>\n<p class=\"css-at9mc1 evys1bk0\">\u201cI told my family,\u201d Ms. Roth said.  &#8220;They didn&#8217;t believe me.&#8221;<\/p>\n<p class=\"css-at9mc1 evys1bk0\">But two years later, she still does not have a trace of cancer.<\/p>\n<\/div>\n<aside class=\"css-ew4tgv\" aria-label=\"companion column\"\/><\/div>\n","protected":false},"excerpt":{"rendered":"<p>It was a small trial, just 18 rectal cancer patients, every one of whom took the same drug. But the results were astonishing. The cancer vanished in every single patient, undetectable by physical exam, endoscopy, PET scans or MRI scans. Dr. Luis A. Diaz Jr. of Memorial Sloan Kettering Cancer Center, an author of a &hellip;<\/p>\n<p class=\"read-more\"> <a class=\"\" href=\"https:\/\/harchi90.com\/small-study-on-rectal-cancer-results-in-remission-in-every-patient\/\"> <span class=\"screen-reader-text\">Small Study on Rectal Cancer Results in Remission in Every Patient<\/span> Read More &raquo;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"default","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","spay_email":"","jetpack_publicize_message":"","jetpack_is_tweetstorm":false,"jetpack_publicize_feature_enabled":true},"categories":[8],"tags":[],"jetpack_featured_media_url":"","jetpack_publicize_connections":[],"jetpack_sharing_enabled":true,"fifu_image_url":"https:\/\/static01.nyt.com\/images\/2022\/06\/05\/science\/05rectal-cancer\/05rectal-cancer-facebookJumbo.jpg","_links":{"self":[{"href":"https:\/\/harchi90.com\/wp-json\/wp\/v2\/posts\/38471"}],"collection":[{"href":"https:\/\/harchi90.com\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/harchi90.com\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/harchi90.com\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/harchi90.com\/wp-json\/wp\/v2\/comments?post=38471"}],"version-history":[{"count":0,"href":"https:\/\/harchi90.com\/wp-json\/wp\/v2\/posts\/38471\/revisions"}],"wp:attachment":[{"href":"https:\/\/harchi90.com\/wp-json\/wp\/v2\/media?parent=38471"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/harchi90.com\/wp-json\/wp\/v2\/categories?post=38471"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/harchi90.com\/wp-json\/wp\/v2\/tags?post=38471"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}