dostarlimab: in patients with mismatch repair–deficient stage II or III rectal adenocarcinoma!

 | Post date: 2022/06/13 | 
Single-agent dostarlimab-gxly (Jemperli) elicited a clinical complete response (cCR) rate of 100% with no evidence of residual tumor among 12 patients with stage II/III mismatch repair–deficient (dMMR) locally advanced rectal cancer, according to data from a phase 2 trial which was conducted in 2022 and published in New England Journal of Medicine. 
Neoadjuvant chemotherapy and radiation followed by surgical resection of the rectum is a standard treatment for locally advanced rectal cancer. A subset of rectal cancer is caused by a deficiency in mismatch repair. Because mismatch repair–deficient colorectal cancer is responsive to programmed death 1 (PD-1) blockade in the context of metastatic disease, it was hypothesized that checkpoint blockade could be effective in patients with mismatch repair–deficient, locally advanced rectal cancer. 
A total of 12 patients involved in this study have completed treatment with dostarlimab and have undergone at least 6 months of follow-up. All 12 patients (100%; 95% confidence interval, 74 to 100) had a clinical complete response, with no evidence of tumor on magnetic resonance imaging, 18F-fluorodeoxyglucose–positron-emission tomography, endoscopic evaluation, digital rectal examination, or biopsy. At the time of this report, no patients had received chemoradiotherapy or undergone surgery, and no cases of progression or recurrence had been reported during follow-up (range, 6 to 25 months). No adverse events of grade 3 or higher have been reported.
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