Medical practitioners suggest that pembrolizumab, a gamechanging immunotherapy drug that reportedly dissolves tumours, could significantly amplify the possibility of beating bowel cancer and may even supersede the requirement for operations. This medication works by targeting and obstructing a distinctive protein present on immune cells, which then find and eradicate cancer cells.
In a clinical trial, it was discovered that administering this drug as a pre-surgery treatment instead of chemotherapy substantially improved the number of patients proclaimed as cancer-free. These findings were revealed at the yearly conference of the American Society of Clinical Oncology (ASCO), the globe’s prime cancer symposium.
The investigation, managed by various prominent universities and hospitals across the UK, prompted Prof Mark Saunders, a high-ranking cancer specialist at the Christie, to declare the trial outcomes as “extremely promising”.
The professor suggests that utilising immunotherapy before surgery has the potential to be revolutionary for patients suffering from this type of cancer. It not only offers better results, but it also safeguards patients from the adverse side-effects of standard chemotherapy. He even postulates that it might take the place of surgery at some point.
Bowel cancer is globally acknowledged as the second most prevalent cause of cancer-associated fatalities. Each year, upwards of 1.9m fresh cases are reported, with over 900,000 succumbing to the disease, per World Health Organization data.
In a study financed by Merck Sharp and Dohme and supervised by University College London, 32 patients presenting with stage two or three bowel cancer and a particular genetic identifier (MMR deficient/MSI-High bowel cancer) were enlisted from five UK hospitals.
Patients with this specific genetic trait account for approximately 15 percent of those living with stage two or three bowel cancer. These patients were then treated with pembrolizumab, often referred to as Keytruda, for nine weeks prior to surgery in lieu of the conventional treatment protocol comprising chemotherapy and surgery, and then observed over a period of time.
The results revealed that, of the treated patients, nearly 59 percent exhibited no cancer presence following treatment with pembrolizumab. Any residual cancer in the remaining 41 percent was successfully eliminated during surgery.
The trial’s primary investigator, Dr Kai-Keen Shiu of UCLH, reported that the use of pembrolizumab has demonstrated significant potential in treating high-risk bowel cancers and boosting the likelihood of an early-stage cure. Notably, the preliminary signs are “extremely optimistic” as all patients were cancer-free post-treatment in the trial. However, Shiu emphasised the importance of continuing to monitor whether these patients remain free of cancer over a prolonged timeline.
According to Shiu, the application of immunotherapy before surgery can actually triple survival chances by eliminating the tumours, and patients with a full response to pembrolizumab have tripled chances of survival. Moreover, patients avoid the challenging side effects of chemotherapy since it isn’t needed after the surgical procedure.
Dr Marnix Jansen from the UCL Cancer Institute stated that more research is needed on pembrolizumab before it becomes a regular treatment option. Nonetheless, given the high calibre of results from this trial, he believes it’s feasible that pembrolizumab may be integrated into clinical practice within a few years if the upcoming trials achieve similar success. An assessment of overall survival and relapse rates will be conducted over the coming years as part of this trial. When patients with this genetic profile were treated with standard chemotherapy, UCL noted that less than 5% showed no traces of cancer after surgery.