From UPSC perspective, the following things are important :
Prelims level : Dostarlimab
Mains level : NA
A trial on 18 colorectal cancer patients in the US found that cancer could be treated without chemotherapy or surgery. The world is sitting up and taking note of Dostarlimab, which has been called a wonder drug.
What is Dostarlimab?
- Dostarlimab is an experimental drug. It contains laboratory-produced molecules.
- It acts as substitute antibodies. It is sold under the brand name Jemperli.
- It was approved for medical use in the United States and the European Union in 2021.
- Its side-effects include vomiting, joint pain, itching, rash, fever etc.
What are the findings?
- The trial showed that immunotherapy alone – without any chemotherapy, radiotherapy, or surgery that have been staples of cancer treatment.
- It could completely cure the patients with a particular kind of rectal cancer called ‘mismatch repair deficient’ cancer”.
- All 12 patients had completed the treatment and were followed for six to 25 months after.
- No cases of progression or recurrence had been reported during the follow-up.
- The response too was rapid, with symptoms resolving in 81% of the patients within nine weeks of starting the therapy.
Is Dostarlimab actually very effective?
- Dostarlimab is not a new drug but a combination of drugs that are already approved for use in immunotherapy.
- There is a possibility that Dostarlimab may improve the outcome and survival rate in rectal cancer patients but to say it as a magic drug for cancer is completely going overboard.
How does this drug cure?
- PD1 is a protein that regulates immune function and can sometimes keep T cells from killing cancer cells.
- The therapy in the trial used PD1 blockades, allowing T cells to kill cancer cells.
- ‘Mismatch repair deficient’ cancer is most common among colorectal, gastrointestinal, and endometrial cancers.
- Patients suffering from this condition lack the genes to correct typos in the DNA that occur naturally while cells make copies.
- Immunotherapy belongs to a category called PD1 blockades that are now recommended for the treatment of such cancers rather than chemotherapy or radiotherapy.
Will Indian patients get access to the drug?
- At present, Indian doctors seem to be generally wary of prescribing Dostarlimab for their patients.
- Experts have termed as optimistic the findings of an ongoing trial—a group of rectal cancer patients showed no signs of a tumour after taking the drug for six months.
- None of the participants reported any severe side-effects either.
- Yet, doctors say they want to assess the duration of the response.
What do we know about the clinical trial?
- Cancer was treated in all the patients and could not be detected by physical examination, endoscopy, positron emission tomography, or magnetic resonance imaging.
- Thus, there is a thought that cancer can be treated without chemotherapy or surgery.
Is it too early to celebrate?
- Cancer specialists said initial signals show how precision medicine is building the future but they need to test more patients from different areas and other types of cancers.
- The combination of drugs was administered to a small number of patients and for a specific type of cancer.