Indian oncologists talk about ‘Dostarlimab’ miracle drug trial that completely eradicates cancer: Do we have a cancer cure in sight?
Dr. Sajan Rajpurohit, Director – Oncology Department at BLK Max Super Specialty Hospital
This trial was carried out on 12 patients and they have published the data, the results are now internationally known. This drug is really helpful in a small group of rectal cancer patients who have a specific genetic abnormality called MMR, called mismatch repair gene deficiency. Therefore, these patients respond very well to this monoclonal antibody. It is an antibody that works by improving the body’s immunity, and it helps the body’s own immunity to destroy cancer cells. The results are really fascinating because all 12 patients responded very well, and after six months, no tumors were seen in their bodies. So the results are very encouraging. How I see the results, although this is the second phase data we have, it seems like a very effective treatment for this small group of patients. And of all cancer patients, 5% will have a deficiency of this cancer cell type. So in these types of tumors, drugs like this can work wonders.
So for cancer cure, cancer is very curable, especially in stage one, sometimes even in stage three. Only stage four is where we really struggle with the cures. But then with these new antibodies that target specific gene abnormalities in cancer cells, we are achieving functional cures even in patients with stage four cancer.
Wesley M Jose, Clinical Associate Professor, Department of Oncology, Amrita Hospital, KochiThis is an important trial to demonstrate the right cancer treatment concept for each patient. However, this experimental drug (Dostarlimab) is not a panacea for all cancers. Dostarlimab is an immunomodulatory drug. Immunotherapy drugs have become another mainstay of cancer care in recent years. There are many drugs (Pembrolizumab, Nivolumab, Atezolizumab, Ipilimumab, etc) similar to Dostarlimab on the market today including the Indian market and will be available at a cancer center near you. But all of these drugs are for very specific indications.
The 12-patient trial was a very small trial (called a phase 2 trial) and was done in patients with rectal cancer (the last part of the large intestine). All of these patients are unique because their cancer is missing a gene called mismatch repair. People with this type of gene abnormality are more susceptible to treatment with immunotherapy. That is the reason for such a response to the treatment. The reason why there are no side effects is because the number of cases is very low and the duration of treatment is relatively short. Dostarlimab could become a very important drug in the cancer treatment room, but it is unlikely to be a magic bullet.
The bigger concern right now is the cost of immunotherapy drugs. An article presented by Tata Memorial Hospital in the same meeting where the Dostarlimab data were presented, reported that only three percent of Indian patients could afford these drugs, which is quite a condition. what a pity. We need not only drugs, but also policies that make these drugs affordable and available to ordinary people. It’s a high order.
As to how soon we will have a cure, that is the hope of every cancer scientist and every cancer researcher. Only time will tell…
Dr Sachin Almel, Medical Oncology Division Coordinator, PD Hinduja Hospital & Medical Research Center, Mumbai
It was tested for rectal cancer with 12 patients, so it’s still early to say it could be groundbreaking but it’s definitely something as these results have never been seen. in clinical trials. It was quite interesting to see how these Immuno checkpoint inhibitors worked and 12 patients were found to be cancer-free.
We need to be aware of this trial, there’s a small group of people that worked on it, plus a very small percentage of patients with rectal cancer would enjoy this treatment. But this is certainly a first step towards more effective cancer care.
Dr. Shishir Shetty, Senior Consultant – Cancer Surgery, Apollo Cancer Center, Mumbai
News of Dostarlimab, a new hope, a revolution in cancer treatment introduced at ASCO has made my phone ring for the past few days. The study was tested on a very small number of patients who were 12 years old. I believe a larger study is needed to proceed with clinical implementation. The estimated cost of treatment will be up to 1.5 crores.
Only a select few cancers with specific biological features (MMR deficiency) qualify (about 5% not all tumours). Without a doubt, it is a revolution in cancer cure and will pave the way for more research and quest to cure cancer without any chemotherapy/radiotherapy or surgery.
However, I believe that the treatment needs to be thoroughly tested in terms of time and application in order to have a solid reputation. By far, surgery is the simplest, cheapest, and most effective treatment for solid tumors.
