HYDERABAD: The good news of a drug trial having cured cancer in patients who took ‘Dostarlimab’, dubbed the wonder drug, has raised the hopes of many. We speak to doctors who explain the science behind the cure, its future in India and if the country is ready for it — money and science-wise. Most say, it is good to be hopeful but at the same time, being over-optimistic is what we need the least right now.
Dr M Srinivas, oncologist, Kamineni-American Oncology Institute, LB Nagar, begins by explaining how and why the drug worked. “It is an immunotherapeutic agent which works by removing blocks for T cells to act on the cancer cells and destroy them. This strategy works well on cancers which have a defective mismatch repair of the damaged DNA,” he shares adding that colorectal cancer, endometrial cancer and other sites of the body may have mismatch repair deficient cancers, hence the drug works on cancers across various systems.
Dr Aditya Chowdary, consultant gastroenterologist, Gleneagles Global Hospital, shares how this drug different from other drugs in the past saying, “Previously we looked for molecules that kill the cancer cells but the new research is focused towards putting a target in the cancer cells to enable our bodies’ own defence systems to take care of them and help us beat cancer.”
Dr Srikanth Marda, paediatric hematologist and oncologist at Ankura Hospital for Woman and Children, Narapally says that though it’s a huge encouraging milestone in treatment modality and appears promising, it’s too early to rationalise. “We need to avoid creating false hopes. It’s just a phase 2 clinical trial conducted in a very small group of 18 patients. The drug is monoclonal antibody and a form of immunotherapy treatment for cancer which works effectively in patients with high MSI, he says, adding that larger studies and longer follow up is required and that long with this, cost involved has to be considered before proclaiming it as a gamechanger and celebrate the drug as definitive standard of care for colorectal cancer.
Dr Vimee Bindra, gynecologist, laparoscopic and robotic surgeon and co-founder of Endocrusaders - Hyderabad, echoes the same need for more trials: “It’s great news but was probably possible because it was tried only on 18 people. If the same results are replicated in a large group of patients only then will we know its accurate efficacy.”
But the burning question now is, how prepared is India for the drug? Dr Aditya replies, “Our country is the pharmacy of the world. We are capable of making any molecule to the highest standard. But, when it comes to usage, we need to understand that majority of spending for health in our country is out of pocket. All the new anti-cancer medications do cost a lot and when we take an example of this drug which may be a couple of lakhs of rupees for each month, it will be out of reach to a majority of our population.” He says that the government is focusing and encouraging the discovery of new molecules in the country itself, citing the example of Covaxin which is indigenously made in India.