Dostarlimab! A name that featured prominently in all the major medical discussions in the last few days. Although some doubts still remain, the world already considers this drug from the British company GlaxoSmithKline nothing less than a miracle. According to the researchers at the Memorial Sloan Kettering Cancer Center in New York Dostarlimab can completely eliminate the disease in people with a specific type of rectal cancer. ‘Dostarlimab’ treatment will be of paramount importance in studies considering we are seeing an alarming increase in rectal cancer among Malayalee youth.
Why Dostarlimab?
During the Covid period, we did hear about various clinical trials of vaccines and drugs. What sets this drug apart is that it has cured all the patients who participated in the Dostarlimab trial. Although there were only 12 patients in the second phase of the trial, the fact that all of them were completely cured makes the world look at this drug with wonder and hope. The main feature of this research was that the disease could be cured without surgery or chemotherapy.
Risk of rectal cancer.
Colorectal cancer or rectal cancer is one of the most dangerous cancers caused by lifestyle changes and diet. Excess fatty foods, processed meats, lack of exercise, obesity, smoking, and alcohol can all contribute to this cancer. Men are more prone to the disease than women. Symptoms include constipation, bloody stools, blackheads, loss of appetite, weight loss, nausea, vomiting, fatigue, and dizziness. But all this shouldn’t make you panicky. It is important to see a doctor as a precaution. If you have any of these symptoms, especially after middle age, you should seek medical attention at regular intervals and get a cancer screening.
Kerala must be careful
The diet followed by a large percentage of people in Kerala increases the risk of rectal cancer to some extent. Excessive consumption of meat, genetically modified poultry, soft drinks, and refined foods like Maida have been found to be a major cause of rectal cancer. The villain is the deoxycholic acid that is formed when they are digested.
How was the experiment?
There are many stages of Cancer. It first appears in a small area. This is stage one cancer. But in the second stage, cancer grows but won’t spread. Stage 3 cancer grows and spreads to other tissues and lymph nodes. Stage 4 cancer spreads to other parts of the body. The Memorial Sloan Catering Cancer (MSKCC) Center's study found that the patients were in stages 2 and stage 3, according to the New England Journal of Medicine.
MMR cancer
All participants in the trial were patients with mismatch repairing cancer. If the DNA repair system fails to function properly, these defects can accumulate and cause cancer. This is called cancer due to mismatch repair. A condition in which DNA bases do not fuse together and fail to repair. To be more precise lack of genes makes it difficult to fix the deficiency in DNA. Rectal cancer is one of the most common types of mismatch repairing cancers.
Immunotherapy
In general, immunotherapy is recommended for cancers caused by a mismatch repair problem. This treatment activates our body's immune system against cancer. It exploits the potential of PD1 protein, which plays a vital role in the body's immune system. As the mismatch repairing cancer progresses, our active immune system becomes completely dormant. Especially T cells in the immune system. This treatment involves the stimulation of T cells by PD1 blockade and the invasion of the cancerous area. That is if the body is assumed to be a car, the system, including the brakes, is the immune system. It is like saying the brakes must be applied correctly in the event of an accident. The PD1 blockade activates the breaking mechanism of T cells.
Nothing new
PD1 blockade treatment is not something new. There is already a treatment that can effectively treat cancer through this method after surgery. This method is also used in cases where the cancerous tissue has spread through the blood to other organs and caused second cancer (metastasis). However, researchers at MSKCC have discovered that the treatment with PD1 blockade can stave off cancer by avoiding surgery. Also, the study suggests that this therapy may be beneficial in the case of all types of mismatch-repairing cancers. The advantage is a much faster cure and fewer side effects than other therapies.
Medication, treatment, and monitoring
Dostarlimab is a synthetic (monoclonal) antibody that has the ability to build strong immunity against a pathogen. The drug should be given once in 3 weeks for 6 months. Researchers claim that results will be visible in a few days. Accordingly, 81% of symptoms may change within 9 weeks of the treatment. They were monitored for 6 to 25 months after completing the course to confirm that cancer had completely vanished. Follow-up treatment does not detect the risk of cancer recurrence or development – MSKCC.
Avoid chemo and radiation
Radiation therapy and chemotherapy are two of the most widely used treatments for cancer. Radiation therapy eliminates and shrinks cancer cells by providing significant radiation. This does not completely eliminate the cancer cells. Therefore, treatment can extend for weeks. It has its own side effects as it also destroys the healthy cells in an attempt to destroy the cancer cells. However, chemo treatment involves the use of drugs that kill cancer cells, and it can completely stop the growth of cancer cells and inhibit growth. This too can have serious side effects.
Life without cancer
Cancer and follow-up treatment routinely make the lives of not only the sufferers but also those around them extremely difficult. But the biggest relief that this new research puts forward is that there won’t be any side effects. With the elimination of chemo and radiation, the general condition of the cancer-stricken life will improve. This is said to positively reflect on your reproductive and sexual health.
How much will it cost?
According to research conducted by MSKCC, the cost of this treatment is unaffordable to the general public. The total cost of the nine-dose course for six months is estimated to be around Rs 77 lakh. An additional cost will go for ancillary inspections. The challenge is that many of the specific drugs needed for immunotherapy are not widely available.
Minus
And there are many people who disapprove of treatment only through Immunotherapy. They point out that at least 10% of all cancer patients do not need surgery and can be cured with chemotherapy and radiation. At the same time, there are those who argue that detailed study and further trials are needed. Defective diagnosis of cells without microscopic study (histology) is indicated. They also point out the need for further testing and long-term monitoring. The argument is strong that a trial involving more people is also needed.
