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A cancer trial’s unexpected result: Remission in every patient

nytimes.com

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Re: A cancer trial’s unexpected result: Remission in every patient

#11

Post by vervez »

rubicon33 wrote: post #7

Fascinating, this drug (molecule) somehow “unmasks” the cancer cells, allowing the body’s natural immune system to target and destroy them. How does a molecule do that!? Enters the blood stream, is absorbed by the cancer cell, and then…? Blocks some enzyme?

Couldn't read the article but yea, if it's a small molecule, most likely it's inhibiting some protein specific to cancerous cells. In this case, it sounds like it's blocking some protein that blocks human cells' innate ability to produce antigens, which signal to T-cells that they are defective and need to be destroyed.

Sometimes we understand the biology after we discover a treatment.

Re: A cancer trial’s unexpected result: Remission in every patient

#13

Post by instagraham »

rubicon33 wrote: post #7

Fascinating, this drug (molecule) somehow “unmasks” the cancer cells, allowing the body’s natural immune system to target and destroy them. How does a molecule do that!? Enters the blood stream, is absorbed by the cancer cell, and then…? Blocks some enzyme?

That is the function of checkpoint inhibitors, according to an explanation I got from a cancer researcher after asking a similar question.

Essential, cancer cells convince the immune system not to attack them, so these inhibitors target the mechanisms by which they do so to get the immune system to take note of these cells. Hope someone more knowledgeable will correct me if I'm wrong.

Re: A cancer trial’s unexpected result: Remission in every patient

#14

Post by dekhn »

SiempreViernes wrote: post #12

Using humans, N = 18. Quick search didn't give any estimate of the chance probability of all going into remission by unrelated reasons, but I imagine it's pretty high compared to the number of small cancer trials run around the world.

Cancer rarely, if ever goes into remission on its own (rectal cancer, specifically). You would never see this happen randomly to everybody in a trial unless there was some external factor.

Re: A cancer trial’s unexpected result: Remission in every patient

#15

Post by ohazi »

rubicon33 wrote: post #7

Fascinating, this drug (molecule) somehow “unmasks” the cancer cells, allowing the body’s natural immune system to target and destroy them. How does a molecule do that!? Enters the blood stream, is absorbed by the cancer cell, and then…? Blocks some enzyme?

It's an antibody.

https://en.m.wikipedia.org/wiki/Dostarlimab

https://en.wikipedia.org/wiki/Pembrolizumab

Re: A cancer trial’s unexpected result: Remission in every patient

#17

Post by gumby »

hprotagonist wrote: post #2

relatedly, the only good reason to stop a trial early is that it becomes unethical not to treat the control group because the effect size in the treatment group is so huge. And it does happen, sometimes.

The other reason is futility: the treatment has no benefit or any improvement is grossly outweighed by side effects.

Re: A cancer trial’s unexpected result: Remission in every patient

#18

Post by sircastor »

thematrixturtle wrote: post #10
orblivion wrote: post #4

Earlier quoted context omitted.

I mean, treat everybody in the world with that condition at that point, right?

The treatment costs ~$100k over half a year.

If this is as effective and reliable as is suggested, this the expense is a cost saving effort. Cancer is an exceptionally expensive disease, at least in the US.

Re: A cancer trial’s unexpected result: Remission in every patient

#19

Post by fisf »

thematrixturtle wrote: post #10
orblivion wrote: post #4

Earlier quoted context omitted.

I mean, treat everybody in the world with that condition at that point, right?

The treatment costs ~$100k over half a year.

That's peanuts in the context of cancer treatment.

Re: A cancer trial’s unexpected result: Remission in every patient

#20

Post by Aransentin »

Some napkin math: Given rectal cancer's rate of survival of 67%, and the small size of the study (18 people), you should see similar results due to random chance every 1350th study.

A cursory search on clinicaltrials.gov and I can find 7131 cancer studies started in 2021 alone. It's therefore not unreasonable for this one to be just a random fluke.

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