The following is an excerpt of an account published by Memorial Sloan Ketting Cancer Center regarding how rectal cancer disappeared in some 14 people following experimental use of immunotherapy. Given there has been a disturbing rise in the number of people under 50 who are diagnosed with colorectal cancer, The Freelance Informer felt readers might be interested in learning about this latest development.
Sascha Roth remembers the phone call came on a hectic Friday evening.
She was racing around her home in Washington, D.C., to pack for New York, where she was scheduled to undergo weeks of radiation therapy for rectal cancer.
Dr. Cercek told Sascha, then 38, that her latest tests showed no evidence of cancer, after Sascha had undergone six months of treatment as the first patient in a clinical trial involving immunotherapy at MSK.
Immunotherapy harnesses the body’s own immune system as an ally against cancer. The MSK clinical trial was investigating — for the first time ever — if immunotherapy alone could beat rectal cancer that had not spread to other tissues, in a subset of patients whose tumour(s) contain a specific genetic mutation.
“Dr. Cercek told me a team of doctors examined my tests,” recalls Sascha. “And since they couldn’t find any signs of cancer, Dr. Cercek said there was no reason to make me endure radiation therapy.”
100% Remission of Rectal Cancer
These same remarkable results would be repeated for all 14 people — and counting — in the MSK clinical trial for rectal cancer with a particular mutation. While it’s a small trial so far, the results are so impressive they were published in The New England Journal of Medicine and featured at the nation’s largest gathering of clinical oncologists in June 2022.
In every case, the rectal cancer disappeared after immunotherapy — without the need for the standard treatments of radiation, surgery, or chemotherapy — and the cancer has not returned in any of the patients, who have been cancer-free for up to two years.
“It’s incredibly rewarding,” says Dr. Cercek, “to get these happy tears and happy emails from the patients in this study who finish treatment and realize, ‘Oh my God, I get to keep all my normal body functions that I feared I might lose to radiation or surgery.’ ”
MSK researchers conducted a prospective study in which single-agent dostarlimab (a GlaxoSmithKline drug), an anti-PD-1 monoclonal antibody, was administered every three weeks for six months in patients with mismatch repair-deficient stage 2 and 3 rectal adenocarcinoma, to be followed by standard chemoradiation and surgery. Patients who achieved a clinical complete response were eligible for omission of chemoradiation and surgery.
No More Symptoms of Rectal Cancer
The results surprised even the doctors.
“The immunotherapy shrank the tumours much faster than I expected,” says Dr. Cercek. “My research nurse Jenna Sinopoli would tell me, ‘The patient has only received one treatment and already they’re not bleeding anymore and their terrible pain has gone away.’ ” Dr. Cercek recalls: “Patients came to my office after just two or three treatments and said, ‘This is incredible. I feel normal again.’ ”
As the first patient to enroll in the trial, the research team was anxious that Sascha’s experience might prove to be an outlier.
Sascha explains: “Before I came to MSK, oncologists at another medical center told me I needed chemo, radiation, and surgery. To instead get immunotherapy infusions every few weeks in New York with no side effects seemed like a cakewalk in comparison.”
It turned out Sascha was not an exception. Dr. Diaz recalls his growing excitement as “the first patient had a complete response to therapy and didn’t need anything else. Then the second patient didn’t need surgery or radiation. Then the third. Pretty soon we’re at the 10th patient that had a complete response. That is incredible.”
Patients, of course, were even more thrilled.
“One young man and his family just sat in stunned silence when I told them his cancer had disappeared,” recalls Dr. Cercek. “Then they thanked us over and over.” She continues, “A young woman looked at the screen during an examination and asked, ‘Where is the tumor?’ ‘It’s gone,’ we told her.”
Dr. Cercek says: “The most exciting part of this is that every single one of our patients has only needed immunotherapy. We haven’t radiated anybody, and we haven’t put anybody through surgery.” She continues, “They have preserved normal bowel function, bladder function, sexual function, fertility. Women have their uterus and ovaries. It’s remarkable.”
Hear from the patients about the treatment they received.
Read the full report here.
There has been a disturbing rise in the number of people under 50 who are diagnosed with colorectal cancer — particularly rectal cancer. Medical oncologist Andrea Cercek who has carried out groundbreaking immunotherapy trials at the Memorial Sloan Kettering Cancer Center (MSK) says: “We are seeing more and more young people with rectal cancer, including people in their 20s in our trial. Immunotherapy might be an important new option for them.”
MSK is also trying to help the growing number of younger patients with the Center for Young Onset Colorectal and Gastrointestinal Cancer. It’s the first centre in the world devoted to the specific needs of people under 50 and is co-led by Dr. Cercek.
Listen to how immunotherapy is transforming the treatment of cancers