A New Drug to Cure Cancer

Dr. Sushil Rudra Ph.D

INTRODUCTION

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Very recent, a new drug ” Dostarmilab” proved to be cured some rectal cancer patients using 6 months. Their cancerous tumour was totally vanished being applied a dose of Dostarmilab every three weeks upto 6 months. This new drug to cure cancer is undoubtedly an historical event in medical science and research.

40 lakh cancer cases, 22.54 lakh deaths reported in India in

India reported over 40 lakh cancer cases and 22.54 lakh deaths between 2018 to 2020, the government told Lok Sabha on Friday.

Union Health Minister Mansukh Mandaviya said that 13,92,179 cancer cases were reported in 2020. (File photo)

More than 40 lakh cancer cases were reported and 22.54 lakh people died of the disease in the country between 2018 and 2020, the government informed Lok Sabha on Friday.

Union Health Minister Mansukh Mandaviya said that 13,92,179 cancer cases were reported in 2020; 13,58,415 in 2019; and 13,25,232 cases in 2018.

As many as 7,70,230 people lost their lives due to cancer in 2020; 7,51,517 in 2019; and 7,33,139 people in 2018, he said in reply to a written question.

The minister said cancer is a multifactorial disease. Its risk factors are of which include an ageing population, sedentary lifestyle, use of tobacco products, alcohol, unhealthy diet and air pollution.

He said that screening of common cancers is an integral part of service delivery under Ayushman Bharat Health and Wellness Centres (HWC).

Mandaviya said the preventive aspect of cancer is strengthened by the promotion of wellness activities and targeted communication at the community level.

Moreover, there is a focus on oncology in its various aspects in the case of 22 new AIIMS and many upgraded institutions under Pradhan Mantri Swasthya Suraksha Yojna (PMSSY), he said.

The minister said the treatment of cancer is also available under Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PMJAY).

Central Government provides financial assistance to patients belonging to families living below the poverty line, suffering from major life-threatening diseases. It is including cancer under the umbrella scheme of Rashtriya Arogya Nidhi and Health Minister’s Discretionary Grant (HMDG), he said.

Furthermore, the minister said that financial assistance up to a maximum of Rs 1,25,000 is provided under HMDG to defray a part of the treatment cost and the maximum financial assistance provided under the umbrella scheme of Rashtriya Arogya Nidhi is Rs 15 lakh.

Mandaviya said he has a fund of Rs 20 lakh under HMDG in a year but he has not given any money yet. Speaker Om Birla then said that the MPs came to know about HMDG only now and there is a suggestion from them that the minister should more frequently utilise it.

­ A NEW DRUG TO CURE CANCER

‘Astonishing’ result in a drug trial: First time, cancer vanishes in every patient

The new study, presented at the annual meeting of the American Society of Clinical Oncology and published Sunday in the New England Journal of Medicine, would change how medicine was practised, cancer specialists said.

On average, one in five patients has some sort of adverse reaction to drugs like the one the patients took, dostarlimab, known as a checkpoint inhibitor. (Representational)

It was a small trial, just 18 rectal cancer patients, every one of whom took the same drug. But the results were astonishing. Cancer vanished in every single patient, undetectable by physical exam, endoscopy, PET scans or MRI scan

Dr Luis A Diaz Jr of Memorial Sloan Kettering Cancer Center, and author of a paper published Sunday in the New England Journal of Medicine describing the results, which were sponsored by the drug company GlaxoSmithKline, said he knew of no other study in which a treatment completely obliterated cancer in every patient.

“I believe this is the first time this has happened in the history of cancer,” Dr Diaz said.

Dr Alan P Venook, a colorectal cancer specialist at the University of California, San Francisco, who was not involved with the study, said he also thought this was a first.

Complete remission in every single patient is “unheard-of,” he said.

These rectal cancer patients had faced gruelling treatments — chemotherapy, radiation and, most likely, life-altering surgery that could result in bowel, urinary and sexual dysfunction. Some would need colostomy bags.

They entered the study thinking that, when it was over, they would have to undergo those procedures because no one expected their tumours to disappear.

But they got a surprise: No further treatment was necessary.

“There were a lot of happy tears,” said Dr Andrea Cercek, an oncologist at Memorial Sloan Kettering Cancer Center and a co-author of the paper, which was presented Sunday at the annual meeting of the American Society of Clinical Oncology.

Another surprise, Dr Venook added, was that none of the patients had clinically significant complications.

On average, one in five patients has some sort of adverse reaction to drugs like the one the patients took, dostarlimab, known as a checkpoint inhibitor.

The medication was given every three weeks for six months and cost about $11,000 per dose. It un- masks cancer cells, allowing the immune system to identify and destroy them.

While most adverse reactions are easily managed, as many as 3 per cent to 5 per cent of patients who take checkpoint inhibitors have more severe complications that, in some cases, result in muscle weakness and difficulty swallowing and chewing.

The absence of significant side effects, Dr Venook said, means “either they did not treat enough patients or, somehow, these cancers are just plain different.”

In an editorial accompanying the paper, Dr Hanna K Sanoff of the University of North Carolina’s Lineberger Comprehensive Cancer Center, who was not involved in the study, called it “small but compelling.” She added, though, that it is not clear if the patients are cured.

“Very little is known about the duration of time needed to find out whether a clinical complete response to dostarlimab equates to cure,” Dr Sanoff said.

Dr Kimmie Ng, a colorectal cancer expert at Harvard Medical School, said that while the results were “remarkable” and “unprecedented,” they would need to be replicated.

The inspiration for the rectal cancer study came from a clinical trial Dr Diaz led in 2017 that Merck, the drugmaker, funded. It involved 86 people with metastatic cancer that originated in various parts of their bodies. But the cancers all shared a gene mutation that prevented cells from repairing damage to DNA. These mutations occur in 4 per cent of all cancer patients.

Patients in that trial took a Merck checkpoint inhibitor, pembrolizumab, for up to two years. Tumours shrank or stabilized in about one-third to one-half of the patients, and they lived longer. Tumours vanished in 10 per cent of the trial’s participants.

That led Dr Cercek and Dr Diaz to ask: What would happen if the drug were used much earlier in the course of the disease before cancer had a chance to spread?

A small biotechnology firm, Tesaro, agreed to sponsor their study. Tesoro was bought by GlaxoSmithKline.

Their first patient was Sascha Roth, who was 38 in 2019.

After being detected with cancer, she was scheduled to start chemotherapy at Georgetown University, but a friend had insisted she first see Dr Philip Paty at Memorial Sloan Kettering.

Dr Paty told her he was almost certain her cancer included the mutation that made it unlikely to respond well to chemotherapy. Roth was eligible to enter the clinical trial. If she had started chemotherapy, she would not have been.

After the trial, Dr Cercek gave her the news. “We looked at your scans,” she said. “There is no cancer.” She did not need any further treatment.

“I told my family,” Ms Roth said. “They didn’t believe me.” But two years later, she still does not.

HIGHLIGHTS:

Tumours vanished in all 18 rectal cancer patients during a drug trial.

The trial was conducted for 6 months.

The cost of the drug (in the trial phase) is approximately Rs 8.55 lakh.

The world may soon be able to get rid of a dreaded disease that is feared for the sheer number of lives it claims — cancer. For the first time, a drug trial has shown 100% eradication of cancer in patients at Memorial Sloan Kettering Cancer Center in Manhattan, US.

The trial, albeit small in scale, has brought hopes that cancer can be removed completely without going through long and painful chemotherapy sessions or surgeries.

According to The New York Times, the drug — dostarlimab — was administered to 18 rectal cancer patients. They seemed to have recovered completely as the disease could not be detected by physical exam.

Doctors examined through endoscopy, positron emission tomography (PET) or magnetic resonance imaging (MRI) scans. Nevertheless, the result is good.

CANCER STATS ACROSS THE GLOBE

The results were “astonishing” and have ushered in hope for billions across the globe. According to the World Health Organisation, nearly 10 million people died in 2020.

Breast cancer accounted for most of the new cases (2.26 million) while lung cancer came in a close second (2.21 million), followed by colon and rectum cancer patients (1.93 million) in 2020.

If further trials on a larger scale show similar results, we could be heading towards a cancer-free world.

Dr Luis A Diaz Jr from the Memorial Sloan Kettering Cancer Center recently published a paper in the New England Journal of Medicine. He said that he was not aware of any other study, in which a treatment “completely obliterated cancer in every patient”.

Furthermore, he said: “I believe this is the first time this has happened in the history of cancer.”

Colorectal cancer specialist at the University of California, San Francisco, Dr Alan P Venook, who was not a part of the team that conducted the study, also said that this was a first. “A complete remission in every single patient is unheard of,” he said.

THE DOSTARLIMAB STUDY: A NEW DRUG TO CURE CANCER

The patients had almost given up their hopes after failing to recover after going through gruelling chemotherapy and radiation sessions.

Some of them even underwent “life-altering” surgeries. It results in the bowel, urinary, and sexual dysfunction. Some of them even had to use colostomy bags.

Not expecting their cancerous tumours to subside, they agreed to be part of the dostarlimab trial. They even expected their current treatment modes to continue.

Despite being their pleasant surprise, they were taken off the painful chemotherapy and radiation sessions and also told that there would be no need to go under the knife.

Another surprise in store for the patients was the complete absence of significant post-treatment complications, which are usually associated with other forms of cancer treatment.

Moreover, there were no signs of recurrence of cancer in the patients until 25 months from the end of the trial, sponsored by the drug company GlaxoSmithKline.

Oncologist at Memorial Sloan Kettering Cancer Center and a co-author of the study Dr Andrea Cercek said: “There were a lot of happy tears.”

HOW THE DRUG WORKS: 6 Week’s Yoga Chart to Reduce Obesity

The patients were administered dostarlimab every three weeks for six months. The medication aimed to unmask cancer cells, allowing the body’s immune system to identify and destroy them naturally.

But such drugs, known as ‘checkpoint inhibitors’, usually have some kind of adverse reaction in 20% of patients who undergo the treatments.

Nearly 60% of patients have severe complications, including muscle weakness. But there is no negative reaction in the patients involved in the dostarlimab study.

Rectal cancer in the patients was locally advanced — tumours. Mainly it had spread in the rectum and, in some cases, to the lymph nodes but not to other organs.

COST OF TREATMENT

The drug, if approved for mass use in future, is not going to come cheap as the trial doses cost $11,000 each or nearly Rs 8.55 lakh per dose.

‘FURTHER TRIALS REQUIRED’ : A new drug to cure cancer

Dr Hanna and K Sanoff of the University of North Carolina’s Lineberger Comprehensive Cancer Center said that it is not clear if the patients are fully cured, despite the results being “compelling”. Although they were not connected to this research.

Moreover, they told :

“Very little is known about the duration of time needed to find out whether a complete clinical response to dostarlimab equates to cure.” Aanoff wrote it in an editorial accompanying the paper.

(With inputs from The New York Times)

However, Dostarlimab has been made in a laboratory. A molecule in this drug has worked as an alternative to antibodies in the human body. And cured 18 rectal cancer patients within 6 months.