Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

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

nytimes.com

Post reply on HN
Print view View original

131–140 of 242 posts

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

#131

Post by fnordpiglet »

rad88 wrote: post #127
Aransentin wrote: post #20

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.

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 irrel…

I bet he’s good at programming though.

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

#132

Post by wonnage »

Aransentin wrote: post #20

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.

Other commenters have done a fine job expressing why this napkin math is silly and perhaps in isolated cases this is a good thing, OP probably learned something here

But in aggregate these sorts of comments are annoying as hell on every medical article posted to HN. Now you have to hope a sufficient mass of well-informed commenters is here to rebut them. In the best-case, these comments are simply misguided, but in the worst case it becomes a watering hole for all the antivaxxers and conspiracy theorists on this site to gather

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

#133

Post by fnordpiglet »

goodpoint wrote: post #47
Aransentin wrote: post #20

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.

Full remission without surgery? This looks much more like tossing a dice 18 times and getting a 6 every single time!

With 1000 sided die perhaps

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

#134

Post by satellite2 »

abirch wrote: post #58
pella wrote: post #23

> It was a small trial, just 18 rectal cancer patients, just 12 "All 12 patients (100%; 95% confidence interval, 74 to 100) had a clinical complete response, with no evidence of tumor on magnetic resonance imaging, 18F-fluorodeoxyglucose–positron-emission tomography, endoscopic evaluation, digital rectal examination, or biopsy. " https://www.nejm.org/doi/full/10.1056/NEJMoa2201445

As with most experiments there's a control group (6 patients). The original statement of 18 participants is correct along with yours of 12 patient treatment group.

A placebo control group when there is an established standard of care? That sounds highly unethical. The above link to the abstract don't mention this and I don't have access to the full text paper. If you do can you clarify what the control arm received?

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

#135

Post by aaaaaaaaaaab »

fnordpiglet wrote: post #131
rad88 wrote: post #127

Earlier quoted context omitted.

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 irrel…

I bet he’s good at programming though.

Most definitely!

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

#136

Post by hahaxdxd123 »

fnordpiglet wrote: post #131
rad88 wrote: post #127

Earlier quoted context omitted.

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 irrel…

I bet he’s good at programming though.

This is one of my favourite HN threads LMAO.

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

#137

Post by lmeyerov »

SnowHill9902 wrote: post #97
robocat wrote: post #94

Earlier quoted context omitted.

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+...

I think he means just solid in the sense that it’s not moving cells.

I think the usual split of solid tumor vs blood (aka 'hematologic' or 'heme')

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

#138

Post by mchusma »

This brings up again the sorry state of medicine being "default banned". Should this treatment be banned for patients? Absolutely not.

Is it a small, underpowered study that needs to be replicated? Absolutely.

Could it warrant banning in the future? Sure.

Should it be covered by insurance? Complicated.

We need to unbundle these things.

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

#139

Post by digisign »

zzzeek wrote: post #32

My 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…

Curious about the drug for non-hodgkins lymphoma, may have helped a friend who passed last year. Too late on one hand, but promising for future folks.

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

#140

Post by abirch »

satellite2 wrote: post #134
abirch wrote: post #58

Earlier quoted context omitted.

As with most experiments there's a control group (6 patients). The original statement of 18 participants is correct along with yours of 12 patient treatment group.

A placebo control group when there is an established standard of care? That sounds highly unethical. The above link to the abstract don't mention this and I don't have access to the full text paper. If you do can you clarify what the control arm received?

I intentionally avoided using placebo group. The control cohort may not have had cancer at all

_____________

The plan is to enroll six patients with MSI, regardless of their primary cancer diagnosis. This cohort will serve to generate hypothesis and initial data to plan a larger study. All analyses from this cohort will be exploratory

https://clinicaltrials.gov/ct2/show/NCT04165772

Post reply on HN