A combination of therapies and surgeries are respectively designed for the treatment of rectum cancer but the possibility of total cure is still less. But recently some doctors came with one procedure where they initiated a phase 2 study where the patients, who are having mismatch repair-deficient stage II or III rectal adenocarcinomas, were given an anti PD-1 monoclonal antibody and single-agent dostarlimab for 6 months in every 3 weeks followed by chemotherapy and surgery.
This particular case has been presented in ASCO at Chicago and published in NEJM, where the discussion was basically on Dostarlimab. Generally, this particular drug cannot be taken orally; usually, it is given in an intravenous way. Though it has been seen that 12 patients with rectum cancer get cured after the usage of this drug, till now there is no significant evidence or study on that. So, 100% assurance of cannot be given in this perspective.
As all the 12 patients who get cured and are not left with any cancer residues are mismatch repair- deficient, it can be said that this particular drug can only work for people with the same mismatch condition.
According to studies only 1.1% among 100 people are having mismatch repair and so the usefulness of the drug Dostarlimab is still a matter of concern. Though on 17th August 2021, USFDA has approved the drug for adult patients with mismatch repair deficient recurrent or with advanced solid tumors, till now the drug is not available in India.
Other immunotherapy drugs are there which is doing a tremendous job in the field of oncology in respective to cure any kind of cancer, whether the new drug is not useful for treating any kind of cancer. Along with that the drugs which are newly get developed are costs around 2.3 crore which is way too costly for general people to afford in our society.
In addition to that all the immunotherapy to cure cancer is cheaper than this medicine, and it is available in India as well as we are using that particular therapy for past 5 long years at Manipal Comprehensive Cancer Centre.
-Prof. Dr. Somashekhar S P, Chairman & HOD Surgical Oncology - Manipal Comprehensive Cancer Center, Manipal Hospital Old Airport Road, Bengaluru