“Treatment for stage II and III rectal adenocarcinomas [which are locally advanced but have not yet metastasized] now routinely includes surgery, radiation therapy, and chemotherapy. The results of recent phase 3 trials have led to an increase in the intensity of treatment to include multiagent chemotherapy in addition to radiation therapy before proctectomy is performed; such treatment has resulted in a 3-year disease-free survival rate as high as 77%. Unfortunately, this treatment approach is grueling and can cause substantial long-term sequelae, including neuropathy, infertility, and bowel and sexual dysfunction,” Dr. Hanna K. Sanoff noted in an editorial in the NEJM that accompanied the study's publication.

While such checkpoint inhibitors can cause adverse reactions in about 20% of patients, severe problems, including muscle weakness and problems swallowing, impact 3%-5%.


In the editorial, Sanoff, of the University of North Carolina’s Lineberger Comprehensive Cancer Center, noted that the study was “small but compelling,” but cautioned that the patients need to be followed to see if they remain cancer-free.

“Very little is known about the duration of time needed to find out whether a clinical complete response to dostarlimab equates to cure,” Sanoff advised.

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