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Dostarlimab – A miracle drug for colorectal cancer


Introduction


Colorectal cancer also known as colon, bowel, or rectal cancer is the third most common type of cancer in terms of its occurrence worldwide owing to about 10 percent of all cancer cases globally. The 5-year survival rate of colorectal cancer is relatively low about 65% in developed countries across the world. Dostarlimab is an emerging cure for colorectal cancer with promising results in clinical trials. Dostarlimab also branded as Jemperli is a programmed death receptor-1 (PD-1)–blocking monoclonal antibody. Currently, Dostarlimab is approved for use in the treatment of mismatch repair (dMMR) recurrent or advanced endometrial cancer which fails to be detected at early stages unsuited for a platinum-based regimen.


Pharmacological Effect


Dostarlimab is a humanized IG4 monoclonal antibody derived from mice antibodies with the help of CDR grafting. Its serum half-life is 25.4 days. Dostarlimab provides its pharmacological effect by binding to PD1 receptors on cancer cells with high affinity and blocks its activity with PD1 ligands. PD1 is a co-inhibitory receptor that is responsible for providing immunity to cancer cells against T cell-mediated response. It protects cancer cells from T cell-mediated Immune response. When PD-1 binds to either PD-L1 or PD-L2 on activated T cells, T cells become inactive and are unable to attack cancer cells. Dostarlimab specifically blocks the interaction of PD-1 with its ligands PD-L1 and PD-L2 allowing the T cells to trigger, target, and destroy cancer cells because of this PD-1 blockage Therefore, blocking PD1 receptors can allow T cells to function normally, and prevent tumor cells from bypassing immune responses. In mouse tumor models Dostarlimab has been shown to significantly reduce tumor growth. \



Research outcomes


In a study of 18 patients with locally advanced mismatch repair–deficient (dMMR) rectal cancer, 6 months of neoadjuvant treatment with dostarlimab alone led to complete remission in 100% of the study’s first 14 patients. The results offer positive early signs of Dostarlimab as the most suitable treatment for colorectal cancer. The study findings were simultaneously published in The New England Journal of Medicine.


Conclusion


Dostarlimab can be seen as a potential cure for colorectal cancers in the future. However, more research and trials are needed to prove its exact efficacy in terms of treatment. Early trials offer promising results favouring the use of Dostarlimab as a potential cure for colorectal cancer in the near future.


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by - RACHIT SANGHAVI .



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