Duchess County, New York — A routine drive to a wedding in Maine turned into a life-altering moment for 71-year-old Maureen Sideris when she discovered she could not swallow her lunch. A subsequent diagnosis revealed gastroesophageal cancer, a condition that obstructed her esophagus and complicated her ability to eat. Standard treatments typically involve a grueling regimen of chemotherapy and radiation followed by surgery to remove affected portions of the esophagus and stomach. However, a groundbreaking clinical trial at Memorial Sloan Kettering Cancer Center provided Sideris with an alternative: immunotherapy.
Dr. Luis Diaz, head of the solid tumor oncology department at the center, described traditional esophageal cancer treatments as often devastating—not just physically but emotionally. “One can overcome it,” he noted, “but the journey leaves a lasting mark on quality of life.” For Sideris, the thought of undergoing such a rigorous treatment was daunting. Instead, she participated in a clinical trial that utilized a single immunotherapy treatment, ultimately leading her to a two-year remission.
The immunotherapy trial was particularly noteworthy for its focus on patients with tumors expressing mismatch repair deficiency. This genetic mutation prevents the correction of DNA errors during cell division, resulting in a higher likelihood of cancer mutations. Dr. Andrea Cercek, who led the trial, emphasized that not all tumors harbor this mutation, which is crucial for the treatment’s effectiveness.
Presenting the findings at a recent cancer research meeting in Chicago, Cercek revealed that the trial began with rectal cancer patients, all of whom had responded positively to the immunotherapy over a six-month period. The results were particularly striking: every participant showed a complete response, eliminating any need for subsequent surgery or chemotherapy. Researchers then expanded the trial to include patients with other cancers also characterized by mismatch repair deficiencies.
Immunotherapy works by harnessing the immune system’s ability to recognize and attack cancer cells. It has shown remarkable efficacy against tumors with mismatch repair deficiencies, as these cancers often exhibit multiple mutations, providing more targets for immune engagement. Despite its promise, immunotherapy is typically not the initial treatment offered for these cancers, which complicates access for some patients.
Sideris’ experience with the trial reflected a broader hope among researchers. Receiving her treatment every three weeks via an IV, she quickly appreciated the convenience and efficacy of this approach. After completing her regimen, she expressed immense gratitude for avoiding the complications commonly associated with cancer surgery.
While Sideris celebrates her remission, some caution remains. Dr. Suneel Kamath from the Cleveland Clinic highlighted that mismatch repair deficiencies are present in only a small percentage of cancers, making this treatment not universally applicable. Still, the potential to eliminate the need for often life-altering surgeries is significant, as patients typically face various challenges such as infertility and a reduced quality of life after such interventions.
The ongoing trials point to an optimistic future where immunotherapy could become a first-line treatment for early-stage cancers showing mismatch repair deficiencies. As research continues, there’s an emerging consensus among oncologists that immunotherapy may soon reshape standard care protocols for certain cancer patients, greatly influencing treatment dynamics.
Dr. Heather Yeo, a surgical oncologist at Weill Cornell Medicine, underscored the potential benefits, emphasizing the need for further studies to validate these findings. The prospect of treating some cancers with immunotherapy instead of traditional methods may soon provide patients with a new lease on life, as researchers work to expand the applicability of these promising therapies.