That said, I would argue that the greatest single medical innovation of the 2010s was the arrival of immune checkpoint inhibitors, the class of drugs to which the newer dostarlimab belongs. It’s been twenty-four years now, though, and while the medicines developed by Dr Folkman helped improve survival for several classes of cancer, Dr Watson’s enthusiasm proved a bit over-ebullient. I remember being very excited at the time. In 1998, the year I started medical school, the same New York Times ran an article quoting Dr James Watson (yes, the “Watson & Crick” Watson) that Dr Judah Folkman’s approach to blocking the growth of blood vessels in tumors would “cure cancer in two years.” I struggle to name more than a couple genuine “game changing” pharmaceutical advances per decade in the four decades I have been watching medicine with a backstage pass. One thing to be wary of when it comes to medical skeptics (and cynics): we tend to be smug, because skeptics tend to have a fantastic track record over time in the medical industry. It helps to understand how this one medication - dostarlimab - fits within the broader context of cancer immunotherapy, to better see how its applications might be limited, despite an increasingly promising future for cancer care in general. There is real cause for optimism, however, and not just for the few thousand people who might be diagnosed with an early stage rectal cancer this year with the right genetic mutation. I am concerned, though, that people reading this headline might feel like we have reached a sudden revolution in overall cancer care. Pretty exciting stuff! To be fair, it really is… for people with a relatively rare subtype of a not-very-common cancer, caught early in their disease process.
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