This cancer clinical trial has had “spectacular” results, but …

HEALTH – The results of this clinical trial would be “unprecedented”. In the New England Journal of Medicine, an article published on June 5 unveiled a clinical study of 12 patients with colorectal cancer. For six months, these patients received a dose of dostarlimab every three weeks. Thanks to this treatment, they will be completely healed.

What conclusions can be drawn? Caroline Moyret-Lalle, PhD in molecular biology, lecturer at Claude Bernard Lyon University 1, and researcher at the Center for Research in Cancerology in Lyon, helps us to see more clearly.

The search acknowledges that the results presented are “spectacular”. “These are metastatic, advanced cancers and there is a real cure, which to my knowledge is unprecedented for colorectal cancers,” she said.

Up to 20% of colorectal cancers

Dostarlimab, which was given to patients in the clinical trial, is part of the so-called immunotherapy treatments, which are “targeting the immune system.” They are relatively recent: they have been tested since 2013 in the United States and 2016 in France.

“In many types of cancer, cancer cells neutralize immune cells, which cannot attack them,” said Dr. Moyret-Lalle. Immunotherapy, combined with chemotherapy, allows immune cells to attack new tumor cells. ”

However, they are not effective in all colorectal cancers. In this clinical trial, the test was performed on a particular type of colorectal cancer, which represents a maximum of 20% of the case, depending on payments.

“These are colorectal cancers that have a particular genetic instability, which is called micro-satellite instability,” she said. That’s not the case with 80-90% of colorectal cancers, so the vast majority. ”

On other colorectal cancers, it would not be so effective at the moment. “They kill the vast majority of colorectal cancers, immunotherapies do not pass the air to get this type of result,” says Dr. Moyret-Lalle. Even though studies are still underway, in France in particular. ”

More important clinical trials

If the researcher wants to be optimistic, she remains cautious. “She is coming to me. The number of patients is low, so she asks for confirmation, she believes. We need to expect slightly larger cohorts of patients and also have results in 80 to 90% of patients who do not have this particular genetic instability. ”

He will have to test several patients. “If you have more results on one or more hundred patients, that will be really interesting,” she hopes. Because we know that with immunotherapies, when you change the scale, sometimes you realize that it is not the care of a few patients and not the majority. ”

According to the New York Times, the price of this drug would be $ 11,000 per dose. A price that seems “within the norm” to look for Caroline Moyret-Lalle. “In France, it’s taken care of,” she said. More on average, immunotherapy is 5,000 or 6,000 euros per injection. “

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