Sascha Roth remembers the phone call that came on a hectic Friday evening.
She was racing around her home in Washington, D.C., to pack for New York, where she was scheduled to undergo weeks of radiation therapy for rectal cancer.
But the phone call from Memorial Sloan Kettering Cancer Center medical oncologist Andrea Cercek changed everything, leaving her, “stunned and ecstatic – I was so happy.”
Dr. Cercek told Sascha, then 38, that her latest tests showed no evidence of cancer, after Sascha had undergone six months of treatment as the first patient in a clinical trial involving immunotherapy at MSK.
Immunotherapy harnesses the body’s own immune system as an ally against cancer. The MSK clinical trial was investigating – for the first time ever – if immunotherapy alone could beat rectal cancer that had not spread to other tissues, in a subset of patients whose tumor contain a specific genetic mutation.
“Dr. Cercek told me a team of doctors examined my tests,” recalls Sascha. “And since they couldn’t find any signs of cancer, Dr. Cercek said there was no reason to make me endure radiation therapy.”
These same remarkable results would be repeated for all 14 people, and counting, in the MSK clinical trial for rectal cancer with a particular mutation.
The hospital says while it’s a small trial so far, the results are so impressive they were published in The New England Journal of Medicine and featured at the nation’s largest gathering of clinical oncologists in June 2022.
In every case, the rectal cancer disappeared after immunotherapy, without the need for the standard treatments of radiation, surgery, or chemotherapy, and the cancer has not returned in any of the patients, who have been cancer-free for up to two years.
“It’s incredibly rewarding,” says Dr. Cercek, “to get these happy tears and happy emails from the patients in this study who finish treatment and realize, ‘Oh my God, I get to keep all my normal body functions that I feared I might lose to radiation or surgery.’”
As the first patient to enroll in the trial, the research team was anxious that Sascha’s experience might prove to be an outlier. Sascha explains: “Before I came to MSK, oncologists at another medical center told me I needed chemo, radiation, and surgery. To instead get immunotherapy infusions every few weeks in New York with no side effects seemed like a cakewalk in comparison.”
It turned out Sascha was not an exception. Dr. Luis Diaz recalls his growing excitement as “the first patient had a complete response to therapy and didn’t need anything else. Then the second patient didn’t need surgery or radiation. Then the third. Pretty soon we’re at the 10th patient that had a complete response. That is incredible.”
Patients, of course, were even more thrilled. “One young man and his family just sat in stunned silence when I told them his cancer had disappeared,” recalls Dr. Cercek. “Then they thanked us over and over.” She continues, “A young woman looked at the screen during an examination and asked, ‘Where is the tumor?’ ‘It’s gone,’ we told her.”
Dr. Cercek says: “The most exciting part of this is that every single one of our patients has only needed immunotherapy. We haven’t radiated anybody, and we haven’t put anybody through surgery.” She continues, “They have preserved normal bowel function, bladder function, sexual function, fertility. Women have their uterus and ovaries. It’s remarkable.”
Drs. Cercek and Diaz want people with rectal cancer tumors that are MMRd to know the clinical trial continues to enroll patients and is growing. Dr. Diaz says, “Our message is: Get tested if you have rectal cancer to see if the tumor is MMRd. No matter what stage the cancer is, we have a trial at MSK that may help you. And MSK has special expertise that really matters.”
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