Dostarlimab is the name of a drug that was used on social media platforms from this week as a synonym for “hope” for a “cure” for cancer. Called a “massive breakthrough,” a study has found that the drug helped treat rectal cancer — for the first time in history.
In all 12 patients, rectal cancer disappeared after immunotherapy for six months without the need for standard treatment of radiation, surgery, or chemotherapy.
Manufactured by GlaxoSmithKline, delivered Not a ‘new’ drug.
It was approved for use in the United States and the European Union in April 2021 and is used to treat endometrial cancer and solid tumors that have progressed on or after prior treatment and who have no satisfactory alternative Treatment is not an option.
The drug, which is a monoclonal antibody marketed under the brand name Gemperly, works by altering the action of the body’s own immune system.
While the test results are encouraging, science experts want to buy more time before calling for victory over cancer.
Separating hype from truth, results of a scientifically published trial in The New England Journal of Medicine conclude that “longer follow-up is needed to assess response duration”.
“The NEJM article clearly identifies the limitations of the study. However it does not speak of cost. The trouble is that the results of the study have been widely publicized and blown out of proportion. People are thinking Whether modern science has finally found a cure for cancer,” wrote Dr. SP Kalantri, professor and medical superintendent of medicine at the Mahatma Gandhi Institute of Medical Sciences, Sevagram, on Twitter. “People are busy forwarding WhatsApp messages that all cancers will be soon Will just disappear. Such broad generalizations do more harm than good.”
Here are six reasons why it’s too early to believe that cancer is now curable:
1. If it Works, It’s for a Very Small Subgroup of Patients
According to Dr CS Pramesh, Director, Tata Memorial Center, a renowned medical institute for the treatment of cancer in India, “MMR deficient rectal cancers account for less than 10% of all rectal cancers.”
“This subgroup of patients was selected because they are extremely sensitive to immunotherapy. Which means the results apply to a small proportion of all patients with rectal cancer,” he wrote on Twitter.
Overall, according to ICMR, the annual incidence rate of rectal cancer among men in India is 4.1 per lakh.
2. The cost of treatment is unviable
Dr Pramesh further wrote that “the cost of treatment is not modest – the total treatment cost of 9 doses of the drug (which were given during the study) is expected to be anywhere from Rs 50 lakh to Rs 1 crore (USD 100,000),” Which puts it out of reach for most patients in LMICs.”
LMICs are low and middle income countries including India.
“If the drug is to be considered beneficial in future studies, the cost needs to be reduced to make it affordable for the vast majority of cancer patients – we must not forget that 70% of all cancers are expected to be reduced.” – and middle-income countries,” he said.
3. No information regarding exemption till now
Public health expert Dr Ash Paul believes that “little is known about the length of time needed to determine whether clinical complete response to dosterlimumab equals recovery or whether patients Exempt…”
He believes the median follow-up is still low, with a median of 6.8 months.
“We know from the OPRA trial that 88% of tumor regrowth can occur up to 2 years after the completion of TNT [total neoadjuvant therapy],” They said.
OPRA is an acronym for the US-based test called Organ Preservation in Rectal Adenocarcinoma.
“Little is known about the length of time needed to ascertain whether a clinically complete response to dostarlimumab equates to treatment,” he said.
Finally, the only endpoint currently available is a composite response, with no data on survival or other clinically relevant outcomes.
4. Small Sample Size of the Study
The study – which was a phase-2 trial – was done on only 12 patients. Experts suggest that these findings should be replicated in a larger trial involving patients from diverse racial and ethnic backgrounds.
Dr JB Sharma, Head of the Department, Action Cancer Hospital, Delhi and Senior Consultant, Medical Oncology, said, “Although the initial indications are positive, we need to go a long way before we can define it as a magic medicine. “
“This is not a new drug, but a combination of already approved drugs that are used for immunotherapy around the world. Some of the drugs used in this combination have already shown positive results when used individually to treat specific cancers.”
5. Single Center-Based Results
All patients were enrolled in just one center – MSK Cancer Centre. The US-based institute, the experts pointed out, “arguably has extensive expertise in the management of rectal cancer”.
Its website claims to have experts in all areas of rectal cancer care who will create a plan specifically for patients. “Our areas of expertise include surgery, chemotherapy, radiation therapy, rehabilitation, follow-up care and quality-of-life issues. The working together of all of MSK’s specialists helps us to ensure that we are able to make sure that we are on course for cancer treatment. choose the best combination of treatments and give you the best possible results,” it says.
6. Success may not be the same in Phase 3 or other cancer trials
Although it has been described as the result of a cancer treatment “for the first time in history”, experts suggest caution and prefer to rely on science and procedure.
Test results may or may not give similar results in other cancers and, therefore, it is too early to announce a cure. cancerfor example.
Dr. Vinay Prasad, a hematologist-oncologist and associate professor at the University of California, San Francisco, describes the test results as impressive at times in his video explainer on his YouTube channel. However, he does not believe the trial’s success can be replicated in other cancer treatments.
“I doubt it would be the case (that) it would work efficaciously (in other cancers)… (the latest results are) impressive, it sounds like you may have stumbled upon a sweet spot,” he says. . “Just cherish it.”
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