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A new drug replaces surgery, chemo in cancer treatment, offers hope to patients

A new drug replaces surgery, chemo in cancer treatment, offers hope to patients

India Today02-05-2025

When Maureen Sideris was told she had cancer in 2022, a tumour at the junction of her esophagus and stomach, her first fear wasn't death. It was losing her voice."I was afraid that if I got surgery on my esophagus, I wouldn't be able to talk for a while," she recalled. "That would have been awful."But instead of going under the knife or through the punishing cycles of chemotherapy, Maureen was enrolled in a clinical trial at Memorial Sloan Kettering Cancer Center (MSK) in New York.advertisement
Her treatment? Just six months of immunotherapy, no surgery, no radiation, no chemo.Today, she is cancer-free.Maureen is one of 84 patients whose tumours disappeared entirely after receiving dostarlimab, an immunotherapy drug, in a phase 2 clinical trial.The results, shared at the 2025 Annual Meeting of the American Association for Cancer Research (AACR) and published in the New England Journal of Medicine, could mark a paradigm shift in how certain cancers are treated.The trial, led by gastrointestinal oncologists Dr Andrea Cercek and Dr Luis Diaz Jr. at MSK, enrolled 103 people with early to locally advanced cancers, including rectal, colon, esophageal, liver, urinary, and gynecologic tumours.
84 out of 103 patients had a complete response to the treatment. ()
advertisementAll had something in common: a genetic signature called MMRd, mismatch repair deficiency.This mutation makes tumours more prone to DNA copying errors, but also more visible to the body's immune system, making them ideal targets for checkpoint inhibitors like dostarlimab, sold under the brand name Jemperli.Checkpoint inhibitors work by taking the brakes off the immune system, allowing it to spot and destroy cancer cells that usually hide in plain sight.The most striking results came from the 49 patients with rectal cancer, every single one had a complete response, meaning their tumours disappeared. Among the other 54 patients with cancers in different organs, 35 also experienced total remission.Crucially, 82 of the 84 patients who went into remission were able to avoid surgery altogether."This study shows that immunotherapy can replace surgery, radiation, and chemotherapy for mismatch repair-deficient solid tumors, which could help patients preserve their organs and avoid the harsh side effects of chemo and radiation," said Dr. Cercek.For years, the standard treatment for many solid tumours, especially those in the digestive and reproductive systems, has been a harsh triad: surgery, chemotherapy, and radiation.
The most striking results came from the 49 patients with rectal cancer, every single one had a complete response, meaning their tumours disappeared. ()
While often effective, these approaches come with heavy side effects: pain, fatigue, infertility, incontinence, loss of sexual function, and long recovery periods.What this new trial shows is that for patients with MMRd cancers, there may be another way.To monitor how well the treatment was working, the researchers used an emerging tool called ctDNA testing, short for circulating tumour DNA.This is a type of liquid biopsy, a blood test that detects tiny fragments of tumour DNA in the bloodstream.Using a technology called Haystack MRD, developed by Quest Diagnostics, they were able to detect whether a tumour had disappeared in as little as 1.4 months.This could make future cancer monitoring not only faster but also safer and more accessible. Out of 103, 49 had rectal cancer. Every single one of them (100%) had a complete response, meaning their tumour disappeared after immunotherapy.The remaining 54 patients had other types of cancer (like colon, liver, esophagus, etc.). Of these, 35 saw their cancers disappear - a 65% success rate.advertisementAltogether, 84 out of 103 patients had a complete response to the treatment. Out of those 84 patients who had a complete response, 82 did not need surgery, a big deal, since traditional cancer treatment often involves removing organs or tissue.Most patients with the specific cancer mutation (MMRd) responded incredibly well to immunotherapy alone, with no need for chemo, radiation, or surgery, especially those with rectal cancer.It's important to note that not all cancer patients will benefit from this treatment.But for those who do have this genetic mutation, the trial offers an entirely new path.The results suggest that in the future, the blood test ctDNA could become an important tool to check how well cancer treatments are working, especially when the tumour is in a part of the body that's hard to reach or cannot be easily seen or tested with a biopsy.For Dr. Cercek and Dr. Diaz, the goal is now to expand this approach to even more types of cancer. You May Also Like

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Kolkata's Daradia Clinic Unveils India's First Web-Based MSK Ultrasound Simulator, Transforming Pain Medicine Training
Kolkata's Daradia Clinic Unveils India's First Web-Based MSK Ultrasound Simulator, Transforming Pain Medicine Training

Business Standard

time5 days ago

  • Business Standard

Kolkata's Daradia Clinic Unveils India's First Web-Based MSK Ultrasound Simulator, Transforming Pain Medicine Training

India PR Distribution Kolkata (West Bengal) [India], June 5: In a major stride for medical innovation in India, Daradia: The Pain Clinic, a globally recognized center for pain management education based in Kolkata, has launched a groundbreaking web-based musculoskeletal (MSK) ultrasound simulator. This state-of-the-art learning tool is designed to teach MSK sonoanatomy essential for ultrasound-guided pain interventions, eliminating the traditional dependence on cadavers, patient volunteers, or expensive ultrasound machines. Unlike conventional simulators that use artificial or computer-generated imagery, Daradia's platform is built entirely on authentic, high-resolution human sonographic images. Learners can explore anatomical structures in both long and short axis views, simulate probe positioning, and repeat procedures as often as needed--all from a browser window, without the need for installation or external hardware. "This isn't just a simulator--it's an educational equalizer," said Dr. Gautam Das, founder of Daradia and a globally respected figure in interventional pain medicine. "Physicians in smaller towns or developing countries often don't have access to cadaveric workshops or ultrasound labs. This tool offers them the same quality of education as those in major academic centers." Designed primarily for pain physicians, the simulator also serves as a valuable resource for specialists in radiology, orthopedics, neurology, anesthesiology, and physical medicine and rehabilitation (PM & R)--fields that increasingly rely on ultrasound-guided procedures for diagnosis and intervention. Early Adoption and Strong Endorsement Since its pilot release, the simulator has drawn nearly 1,000 users from India and abroad. Structured feedback from 131 early adopters reveals its strong educational impact: * 94% of users had previous hands-on training with cadavers or volunteers. * The simulator received a recommendation score of 9.48/10. * Image realism was rated 8.96/10. * Its usefulness for clinical application scored 9.16/10. "I've attended cadaver workshops, but they last a day. This simulator let me revisit and study the shoulder anatomy over multiple sessions, which deepened my understanding," shared one participant. The simulator provides a self-paced, repeatable learning experience with labeled anatomical structures, scanning paths, and region-wise navigation, enabling users to build visual and spatial understanding critical for interventional techniques like nerve blocks and fascial plane injections. Built by Clinicians, Engineered for Doctors The innovation is a result of a highly collaborative effort between clinicians and technology experts. Dr. Sushpa Das, senior pain specialist and a lead contributor, highlighted the tool's educational design: "This is more than a simulator--it's a structured learning journey through MSK anatomy. We created it to let learners build a clear mental map of anatomical relationships in ultrasound, even before handling a real probe." The technical architecture was led by Ms. Nandini Vanzara, an engineer whose expertise shaped the platform's performance and usability: "Balancing high-quality real images with smooth web delivery was our biggest challenge. We designed the interface around how clinicians think--everything from the scan flow to labeling is intuitive and efficient," she said. The simulator runs on any modern browser, on both desktop and mobile devices, ensuring maximum accessibility. It includes features like step-wise scanning instructions, labeled cross-sections, and probe navigation tips to emulate a real-world scanning experience. Addressing a Critical Educational Gap As the demand for ultrasound-guided interventions grows globally, the gap in structured training--especially in MSK sonoanatomy--remains a challenge. In many regions, access to cadaver labs or live USG workshops is limited, either by cost or geography. "Even experienced doctors may not get adequate MSK ultrasound exposure," said Dr. Das. "This simulator allows physicians to practice frequently, pause and review, and gradually build mastery--without the need for physical infrastructure." This simulator is part of Daradia's broader mission to expand access to evidence-based pain education. The clinic already conducts online and offline fellowships, cadaveric workshops, and hands-on training for interventional pain procedures. Its educational outreach spans Asia, Europe, and the Middle East. Try It Now To encourage widespread adoption and collect feedback, Daradia is offering a free trial module of the simulator. Interested physicians can register at: To explore Daradia's broader educational offerings--including pain fellowships, simulation tools, and academic events--visit:

THIS diet can delay the progression of cancer, experts reveal
THIS diet can delay the progression of cancer, experts reveal

Time of India

time03-06-2025

  • Time of India

THIS diet can delay the progression of cancer, experts reveal

A recent pilot study reveals that a high-fiber, plant-based diet can significantly improve metabolic health and gut microbiome diversity, potentially delaying cancer progression. Researchers at Memorial Sloan Kettering Cancer Center found this diet particularly beneficial for individuals at risk of multiple myeloma. Cancer is a leading cause of death worldwide, accounting for nearly 10 million deaths in 2020. According to the World Health Organization, about 1 in 5 people develop cancer in their lifetime, and approximately 1 in 9 men and 1 in 12 women die from the disease. Diet plays a significant role in cancer prevention. A new clinical trial has now found that a certain diet can improve health markers that could delay progression to cancer. The pilot study, led by researchers at Memorial Sloan Kettering Cancer Center, found that a diet significantly improved metabolic health, inflammation markers, and gut microbiome diversity, all of which play a role in cancer progression. The findings will be presented at NUTRITION 2025, the flagship annual meeting of the American Society for Nutrition held in Orlando. Diet to fight myeloma The clinical trial suggests that a high-fiber plant-based diet could benefit patients at risk for developing multiple myeloma, the second most common type of blood cancer. The study found that this diet was also linked to improvement in certain factors that can potentially delay the progression of precancerous conditions that can lead to multiple myeloma. Multiple myeloma often starts with early, non-cancerous conditions that involve abnormal plasma cells. Lifestyle factors such as a high body weight, a poor-quality diet, and an unhealthy balance of gut bacteria have been shown to increase the risk of it progressing to multiple myeloma. 'With cancers being detected earlier and precancerous states identified more frequently, there is a growing opportunity to understand how modifiable risk factors, like diet and lifestyle, affect cancer progression. Our results highlight the importance of improved dietary quality in early disease states and could provide guidance for future clinical trials,' Francesca Castro, a clinical research dietitian at Memorial Sloan Kettering Cancer Center, said in a statement. Nutrition and cancer The researchers have stressed the importance of diet in decreasing the risks of cancer . 'With everything that patients cannot control during and before cancer treatment, studying diet provides an opportunity for patients to make a difference in their disease risk and the potential success of their treatment. Our study shows the power of nutrition in the preventative setting and showcases the potential to give patients a sense of agency in their diagnosis,' Urvi A. Shah, MD, a physician scientist at Memorial Sloan Kettering Cancer Center and principal investigator for the research said. The study The trial included 20 patients with elevated body mass index and precancerous markers for multiple myeloma. Participants followed a 12-week high-fiber, plant-based meal plan, along with 24 weeks of tailored nutritional counseling, and were monitored over 52 weeks. The participants were encouraged to eat to satiety as long as they consumed whole plant-based foods such as fruits, vegetables, nuts, seeds, whole grains, and legumes. Refined grains, animal products, added sugar and highly processed foods were avoided from the diet. The researchers found that the high-fiber, plant-based diet contributed to dietary adherence and weight loss. Prior to the study, only 20% of total calories came from high-fiber plant-based foods, whereas by the end of the 12 weeks, that number jumped to 91%. The median BMI dropped by 7% by the end of 12 weeks and this weight loss was sustained at 1 year. Two patients experienced a slowing of disease progression, while progression remained stable in the others. Trump's Health Secrets EXPOSED? Nearly HALF of America Thinks Prez is HIDING Medical Truths | WATCH 'Our study had diverse racial enrollment as well as a comprehensive dietary and biomarker evaluation. Our comprehensive analysis of improved immune and metabolic response suggests that a high-fiber plant-based diet can also reduce risk for cardiovascular conditions, diabetes, and other metabolic conditions,' Shah said. Takeaway Most people consume less than the recommended daily fibre. The researchers suggest setting realistic daily goals and focusing on one meal at a time, to boost fiber in the diet. 'Think about what foods you can add or swap to increase fiber intake. It can be very simple, like adding a piece of fruit at the end of a meal or swapping out a refined grain for a whole grain. Eating more fiber can lower risk for many other conditions and can improve overall health, beyond just reducing cancer risk,' Castro said. One step to a healthier you—join Times Health+ Yoga and feel the change

Precision Medicine and Low-Dose Radiation Are Transforming Head and Neck Cancer Care
Precision Medicine and Low-Dose Radiation Are Transforming Head and Neck Cancer Care

Time of India

time20-05-2025

  • Time of India

Precision Medicine and Low-Dose Radiation Are Transforming Head and Neck Cancer Care

New Delhi: Globally, over 900,000 new cases of head and neck cancer are diagnosed annually. The treatment landscape for head and neck cancers (HNCs) has undergone a dramatic shift over the past two decades, with precision medicine , immunotherapy, and functional preservation leading the way. Dr Jatin P. Shah, Head and Neck Surgeon at Memorial Sloan Kettering Cancer Center (MSK), shares how these advances are transforming care, improving outcomes, and reducing toxicity—especially relevant for India, where HNCs remain a significant public health challenge. 'The most important development in recent years is the ability to identify the genetic mutations and fusions that drive these cancers,' says Dr Shah. Through molecular profiling, clinicians can now tailor therapies to a tumor's genetic fingerprint—a hallmark of precision oncology. MSK's proprietary IMPACT assay exemplifies this approach, analyzing hundreds of cancer-related genes to identify targetable mutations. 'This is particularly promising for patients with rare or treatment-resistant head and neck cancers,' he explains, 'as it offers new hope when conventional therapies fail.' However, while targeted therapies are powerful, only a limited number of mutations are currently druggable. Immunotherapy, on the other hand, has seen broader applications. 'It's now routinely used in recurrent, metastatic, and even some advanced-stage patients before surgery,' Dr. Shah notes. HPV-Positive Cancers: High Cure Rates, Lower Side Effects One of the most notable breakthroughs has been the recognition of HPV-positive oropharyngeal cancers, which respond remarkably well to treatment. Globally, HPV-related head and neck cancers are on the rise, particularly in younger, non-smoking individuals. HPV accounts for up to 70 per cent of oropharyngeal cancers in some populations, and these cancers tend to have better outcomes. According to Dr Shah, the challenge now is to maintain high cure rates while minimizing long-term side effects. MSK is leading a promising clinical trial using low-dose radiation (30 Gy) for HPV-positive patients. 'Early results show excellent tumor control with far fewer side effects compared to traditional high-dose radiation,' he reports. This marks a potential paradigm shift in how these cancers are treated. Radiation Therapy: No Longer 'One Size Fits All' Radiation therapy has historically been viewed as a blunt tool—powerful but often associated with severe side effects. That perception is changing. 'One of the biggest misconceptions is that all patients require the same high radiation dose,' Dr. Shah says. 'Today, radiation is personalized, just like surgery.' Advances in imaging, diagnostics, and tumor biology now allow clinicians to customize doses and target areas, reducing damage to healthy tissues. Dr Shah highlights emerging treatments for aggressive head and neck cancers, including sinonasal carcinomas and salivary gland tumors. 'We're testing chemo-immunotherapy combinations to either avoid or limit surgery, preserving function and appearance.' For rare salivary gland tumors like salivary duct carcinoma, researchers are targeting molecular markers such as the androgen receptor and HER2, similar to therapies used in prostate and breast cancer. 'These targeted treatments represent a leap forward in personalizing care for even the rarest tumor types,' he adds. India's Head and Neck Cancer Burden: Prevention is Key India bears one of the highest burdens of head and neck cancers globally, largely due to the widespread use of tobacco products, including gutka and pan masala. India accounts for nearly 30 per cent of global cases of oral cancer, with tobacco use being the leading cause. 'Head and neck cancer is largely preventable,' Dr. Shah emphasizes. 'Avoiding tobacco—both smoked and chewed—is one of the most effective strategies.' He urges healthcare providers in India to promote early detection, especially for symptoms like persistent mouth ulcers, voice changes, or difficulty swallowing. With modern medicine advancing rapidly, the focus in head and neck oncology is increasingly on individualized care—delivering the most effective treatments while preserving quality of life.

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