Immunotherapy as a Potential Alternative to Surgery for Certain Cancers, Improving Patients' Quality of Life

Recent clinical trial findings from Memorial Sloan Kettering Cancer Center reveal that immunotherapy alone can effectively treat mismatch repair-deficient (MMRd) cancers, potentially eliminating the need for traditional surgery and preserving patients' quality of life. The study, presented at the AACR 2025 Annual Meeting and published in the New England Journal of Medicine, demonstrated that 80% of participants avoided surgery, radiation, and chemotherapy after six months of immunotherapy treatment.

Gastrointestinal oncologists Andrea Cercek, MD, and Luis Diaz Jr., MD, emphasized that this breakthrough approach not only successfully controlled the cancer but also spared patients from the debilitating side effects commonly associated with conventional treatments. Dr. Cercek highlighted that this strategy allows patients to maintain their independence and return to normal routines, marking a significant shift in cancer management.

The trial involved 103 patients with stage 1–3 cancers, including rectal, gastroesophageal, hepatobiliary, colon, genitourinary, and gynecologic cancers. All received dostarlimab (Jemperli), a PD-1 inhibitor, for six months. Checkpoint inhibitors like dostarlimab work by empowering the immune system to recognize and attack tumor cells. Remarkably, most patients experienced complete tumor disappearance without the need for invasive procedures.

This was a groundbreaking extension of earlier research where all rectal cancer patients treated with dostarlimab showed complete clinical response. The FDA granted this drug Breakthrough Therapy Designation for rectal cancer in December 2024.

The study also showcased the role of circulating tumor DNA (ctDNA) testing via Haystack MRD as a reliable method for monitoring treatment response, potentially allowing for less invasive assessments in future therapies. Both Drs. Cercek and Diaz aim to expand this immunotherapy-based approach to other cancer types, harnessing its potential to revolutionize cancer treatment.

The findings suggest that for certain cancers with specific genetic mutations, immunotherapy might replace traditional therapies like surgery, reducing physical and emotional burdens and improving patients' overall well-being.