Immunotherapy saves patients with cancer from gruesome surgery and raw therapies

When a person develops solid tumors in the stomach, esophagus or rectum, oncologists know how to treat them. But medicines often have a sedate impact on the quality of life. This may include removal of a stomach or bladder, a lasting bag of colostomy, radiation that causes infertile patients and lasting damage during chemotherapy.

So the research group at Memorial Sloan Kettering Cancer Center, using a drug from the pharmaceutical company GSK, tried something different.

Scientists started 103 people with a group. The participants of the study were among 2 to 3 percent of cancer patients with tumors, which should react to immunotherapy, a drug that overcomes barriers that prevent the immune system from attacking.

But in clinical trials, immunotherapy should not replace standard treatment methods. Scientists, led by dr Luis A. Diaz Jr. and Dr. Andrea Kurcek, they decided to give suppliedindependently immunotherapy.

The result was stunning and could bring hope for a constrained group of patients fighting these cancers.

In 49 patients who had rectal cancer, the tumors disappeared and did not return after five years. Tumors also disappeared for 35 out of 54 patients, including other cancers, including in the stomach, esophagus, liver, endometrial, urinary tract and prostate.

Of all 103 patients, the cancer only returned in five. Three got additional doses of immunotherapy, and one that the tumor returned in the lymph node, the lymph node was removed. These four patients have no evidence of illness. The fifth patient had additional immunotherapy that caused a tumor reduction.

Investigators reported their results on Sunday at the annual American Association for Cancer Research and in paper Published in the Fresh England Journal of Medicine.

The results, said Dr. Bert Vogelstein, oncologist with Johns Hopkins in Baltimore, are “breakthrough”.

Earlier phases of the drug development took place in his laboratory and was surprised to watch his progress.

“Twenty or 30 years ago, the idea that you can take immense tumors of many different organs and treat them without surgery would seem science fiction,” he said. He added, however, that the discovery did not fully appear in the minds of scientists. Instead, he noticed, he was based on 40 years of research “starting with very basic science.”

The reason why immunotherapy even had a chance against these immense tumors is that patients’ tumors had so -called mutations for repairing mismatch in their genes, which prevented them from determining DNA damage. As a result, such tumors are blown up with unusual proteins that signal the immune system to destroy them. But tumors place a shield that blocks the immune attacks. Immunotherapy pierces the shield and allows the immune system to destroy the tumors.

In the case of patients such as people in the study, said Dr. Michael Overman, a specialist in gastrointestinal cancer at MD Anderson Cancer Center in Houston, the results show immunotherapy without chemotherapy, radiation therapy or surgery is an vital treatment “and it is so logical that we should do it.”

But for now it may not be so uncomplicated. The drug costs about USD 11,000 per dose, and patients need nine infusion within six months. To obtain insurance protection, the drug must be included in clinical guidelines, sets of recommendations for treatment produced by professional organizations.

It is approved as the treatment of uterine cancer with mounding mutations and is included in the clinical guidelines for the treatment of rectal cancer, based on previous tiny tests. Diaz said, however, that patients with other cancers may have a problem with obtaining the drug. Memorial Sloan Kettering continues to recruit their clinical trial, so patients who have tumors with non -finished repair mutations and qualify for the examination can release the drug.

For some patients, immunotherapy was wonderful. It can have side effects – the most common among patients in the study were fatigue, rash and itching. Sporadic side effects included lung infections and encephalitis.

Maureen Sideris, 71, from Amnia, Fresh York, learned that she had cancer after she tried to eat a hamburger.

“It won’t fall,” she said. There was some blek. It turned out that this was a tumor on the tilt of her stomach and esophagus.

She went to Sloan Kettering in 2019. Her surgeon told her that she needed surgery, chemotherapy and radiation and that the surgery would be arduous – maybe they would have to remove a piece of stomach and move the esophagus of the esophagus

But her tumor had a miracle repair mutation, so she joined a clinical trial. The first infusion took place on October 14 this year. Until January, her tumor disappeared. Mrs. Sideris has one side effect from treatment – she must now take medicine to improve the functioning of its kidneys. However, he says that it is worth paying this price to avoid troublesome treatment that would have anything for her.

“It was a journey,” she said. But, she added, she justified that she had nothing to lose when she agreed to try immunotherapy.

“I still had surgery as support, if it didn’t work,” she said.