Andrea Cercek, MD, on Rectal Cancer: Durable Complete Responses to PD-1 Blockade Alone
2024 ASCO Annual Meeting
Andrea Cercek, MD, of Memorial Sloan Kettering Cancer Center, discusses expanded data on the durability of complete response to dostarlimab-gxly, a PD-1 single-agent therapy administered to patients with locally advanced mismatch repair–deficient rectal cancer. The drug yielded recurrence-free responses, lasting longer than a year, without the need for chemotherapy, radiation, or surgery (LBA3512).
Transcript
Disclaimer: This video transcript has not been proofread or edited and may contain errors.
We're presenting data on the durability of clinical complete responses in mismatch repair-deficient locally advanced rectal cancer to PD-1 therapy alone. We designed a phase II clinical trial of neoadjuvant PD-1 blockade with dostarlimab in mismatch repair-deficient rectal cancer, with the idea that we could use immunotherapy alone, dostarlimab alone to treat locally advanced rectal cancer, and potentially omit standard approaches to therapy, including chemotherapy, radiation, and surgery. And we initially presented the data two years ago. In June of 2022, we noted complete responses, 100% complete responses in 14 consecutive patients. So now we're presenting the expanded data. The trial has been ongoing, and we continue to see a hundred percent complete clinical responses now in 42 patients treated with dostarlimab.
None of our patients have needed chemotherapy, radiation, or surgery. The second primary endpoint of the trial was the durability of these complete responses. And we have seen now that 24 patients have had more than a year of complete clinical responses after completion of dostarlimab. Really showing that not only are we seeing 100% complete responses, but that these responses are in fact durable in patients. And in terms of quality of life, this has been incredibly impactful for patients. None have needed chemotherapy, radiation, or surgery. And we've seen very little toxicity, only grade 1 or 2 toxicity on trial to dostarlimab, so the patient's quality of life is maintained after treatment.
There is now a global study called AZUR-1 with the same exact design, looking at neoadjuvant therapy with dostarlimab in mismatch repair-deficient rectal cancer. Which is a registration study that will hopefully provide care to all patients with early-stage mismatch repair-deficient rectal cancer, and change the standard of care in this population.
Related Videos
The ASCO Post Staff
Mazyar Shadman, MD, MPH, of Fred Hutchinson Cancer Center, discusses a network meta-analysis showing that zanubrutinib appears to be the most efficacious Bruton’s tyrosine kinase (BTK) inhibitor for patients with high-risk relapsed or refractory chronic lymphocytic leukemia. It offers delayed disease progression and favorable survival and response, compared with alternative BTK inhibitors (Abstract 7048).
The ASCO Post Staff
Jean-Marc Classe, MD, PhD, of France’s Nantes Université, discusses phase III results showing that systematic lymphadenectomy should be omitted in patients with advanced epithelial ovarian cancer with clinically negative lymph nodes, as well as those undergoing neoadjuvant chemotherapy and interval complete surgery (LBA5505).
The ASCO Post Staff
Alicia Morgans, MD, MPH, of Dana-Farber Cancer Institute, and Susan Halabi, PhD, of the Duke Cancer Institute and Duke University School of Medicine, discuss a clinical-genetic model that identified novel circulating tumor DNA alterations that are prognostic of overall survival and may help to classify patients with metastatic castration-resistant prostate cancer into risk groups useful for selecting trial participants (Abstract 5007).
The ASCO Post Staff
Efrat Dotan, MD, of Fox Chase Cancer Center, discusses results from the phase II EA2186 trial, the first prospective study aiming to define the optimal treatment approach for vulnerable older adults with newly diagnosed metastatic pancreatic cancer (Abstract 4003).
The ASCO Post Staff
Reshma Jagsi, MD, DPhil, of Emory University Winship Cancer Institute, and Tarah J. Ballinger, MD, of Indiana University Simon Comprehensive Cancer Center, discuss the disparate burden of taxane-induced peripheral neuropathy in Black women with early-stage breast cancer and how a tailored trial for this population showed that using docetaxel as the preferred taxane may be beneficial (LBA503).