As a survivor of colorectal cancer, this is great news, even though the sample size is small and further studies are obviously needed. I'm hoping that by the time my children are at an age where they're at risk, treatments like this will be a well-established standard of care.
A cancer trial’s unexpected result: Remission in every patient
121–130 of 242 posts
Re: A cancer trial’s unexpected result: Remission in every patient
#122[deleted]
Re: A cancer trial’s unexpected result: Remission in every patient
#123I got to spend a couple of weeks as an internal medicine intern with a medical oncologist who incidentally worked at memorial sloan prior to coming to my university. You could tell how excited he was about the current state of cancer research and new treatments, especially with immunotherapy.
Wonder if docs will start off-label treating earlier with immunotherapy. There's tons of immune checkpoint inhibitors meant for different types of cancers and mutations.
Re: A cancer trial’s unexpected result: Remission in every patient
#124Earlier quoted context omitted.
For leukemia, there are a lot of promising new treatments and clinical trials. For metastatic solid-state tumors, much less. We're still in the dark ages of cancer treatment.
FYI: your comment is a unique result for “metastatic solid-state tumors”[1], so much much less? [1] https://www.google.co.nz/search?q=%22metastatic+solid-state+...
We talking tumors in the state of metastatic solid?
Re: A cancer trial’s unexpected result: Remission in every patient
#125My dad was fortunate enough to get into a trial at Sloan for Obinutuzumab for Chronic Lymphocytic Leukemia. At the moment, after 6 weeks of treatment, the percent of cancerous cells in his bone marrow has gone from 95% to 5%. The treatment was very intense as it overloads the kidneys on the first few treatments due to the dramatic amount of cells being flushed out. This is a cancer for which there was not much treatm…
Similar story to the husband of my sister-in-law's sister (I think that's how you say it).
Metastatic Melanoma, had spread to his stomach. Got on the trial for Ipilimumab and is still here a decade and change later.
Re: A cancer trial’s unexpected result: Remission in every patient
#126Some 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.
There should be some kind of award for these kinds of "well actually" comments on HN that lack any kind of intuition for the domain.
Cartoon montage: "By my calculations..." followed by driving a car off a bridge.
Edit: as someone who works in cancer research, I can tell you that your prior for 18/18 locally advanced colorectal cancer patients achieve CRs without surgery should be ~0.
Re: A cancer trial’s unexpected result: Remission in every patient
#127Some 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.
This analysis is mindless and inappropriate. If you care about this at all do yourself a favor and just read the study.
https://www.nejm.org/doi/full/10.1056/NEJMoa2201445
Otherwise redo your napkin math and cursory search to answer, specifically, whether all these cancers disappearing within weeks of dostarlimab treatment could be a fluke. And do not compare this to "rectal cancer's rate of survival", which is irrelevant and a completely different set of (parametrized) statistics, and also do not compare it to the total number of "cancer studies", which was an arbitrary choice and yielded this meaningless conclusion. Even if this kind of analysis was useful, why did you compare against the number of cancer studies, rather than rectal cancer (1910), or dostarlimab (41), or studies with the same staging and genetic pathology? It's meaningless.
I don't believe you're qualified to tell anyone about the significance of this study, and much less dismiss it as a fluke.
Re: A cancer trial’s unexpected result: Remission in every patient
#128This experiment of treating cancer with checkpoint inhibitors before chemotherapy should be widened to all cancers where the CI is available and effective as soon as possible, as it can cure lots of lives. I'm worried that it will take many years until that happens.
> I'm worried that it will take many years until that happens. For good reason. If we detect cancers early, surgery and radiation are often very good nowadays--often allowing you to skip chemotherapy. And these are far less likely to kill the patient than a checkpoint inhibitor (which can overload your kidneys if it works or give you autoimmune diseases even if it doesn't). The problem is that there are a lot of canc…
My ex girlfriend detected breast cancer early at age 28, but the doctors told her that she's ,,too young'' to have cancer. 1 year later on the checkup they said that it's too late (she has BRCA1 mutation). The last 10 years have been fighting with cancer, having about 10 operations on her, but the worst thing was chemotherapy (she said that she would rather die than go through it again, I think the dose had been too large for her probably as well, as she's 44kg). The cancer went away and came back multiple times, and it got so bad that we had to separate, but she's still my best friend (and I didn't find any other person to spend my life with).
She's right now on an experimental checkpoint inhibitor (stage 4 metastatic since a year ago), and it probably gives her another few months, but every time I see her I think that she only has a year left in her life and get sometimes frustrated that the experiments are not optimized to get the more effective treatments in earlier stage.
Re: A cancer trial’s unexpected result: Remission in every patient
#129Earlier quoted context omitted.
For leukemia, there are a lot of promising new treatments and clinical trials. For metastatic solid-state tumors, much less. We're still in the dark ages of cancer treatment.
What treatments in particular?
Imatinib (Gleevac) revolutionized treatment for patients with chronic myeloid leukemia (CML). Prior to the drug’s discovery, CML patients generally had seven years to live (possibly less depending on how advanced the cancer was). Now their lifespan mirrors the general population.
I’d highly recommend the book The Philadelphia Chromosome if you’re interested in learning more.
Re: A cancer trial’s unexpected result: Remission in every patient
#130My dad was fortunate enough to get into a trial at Sloan for Obinutuzumab for Chronic Lymphocytic Leukemia. At the moment, after 6 weeks of treatment, the percent of cancerous cells in his bone marrow has gone from 95% to 5%. The treatment was very intense as it overloads the kidneys on the first few treatments due to the dramatic amount of cells being flushed out. This is a cancer for which there was not much treatm…
Similar story to the husband of my sister-in-law's sister (I think that's how you say it). Metastatic Melanoma, had spread to his stomach. Got on the trial for Ipilimumab and is still here a decade and change later.
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