Immunotherapy treatment helps some rectal cancer patients avoid surgery

Doctors in France and internationally are using a specific immunotherapy drug called dostarlimab to treat patients with locally advanced rectal cancer.

This treatment allows some patients to eliminate tumors without undergoing surgery, chemotherapy, or radiotherapy. It specifically targets patients who possess a particular genetic profile. The Azur-1 international trial involving 154 patients confirmed that this approach provides a clinically significant benefit.

Results from the trial showed that patients maintained a complete response, meaning no detectable trace of the tumor remained, for at least 12 months. While this represents a major shift in care, Olivier Bouché, a digestive oncology specialist at the CHU de Reims, notes that this specific treatment only applies to 15% of patients. For patients who do not have the required genetic profile, doctors use a total neoadjuvant treatment that combines chemotherapy and chemoradiotherapy before any surgical decision.

This method has doubled the complete response rate from 15% to 30% in recent years. When a tumor is no longer detectable, patients can choose a "Watch and Wait" strategy. This involves regular monitoring through MRIs and endoscopies every three months instead of immediate surgery. About half of the patients choose to keep their rectum rather than undergo the operation.