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.
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.
Pun intended?
I concede that if a quick remission is extremely rare that does change the outcome, though I don't know how common that it.
Picking 'Total number of "cancer studies"' was not arbitrary. A similar article could have been crated for e.g. "promising drug cures breast cancer" so you need to take all of them into account. Actually probably every study conducted of all high-profile diseases that are likely to wind up on the HN frontpage - in a counterfactual universe we could be discussing a miracle Alzheimer drug or the like.
If you don't even know whether spontaneous remission is rare then you should not be offering an opinion about this. It's not even pertinent because these remissions were clearly not spontaneous, but it should alarm you to have spoken so recklessly about a disease which is essentially fatal. What you're saying amounts to "there's a good chance cancer just goes away on its own". Incidentally, this is also the least amount of math I've ever seen in a napkin math argument.
> [sponanteous remission of cancer] incidence is roughly one in every 60 000–100 000 cancer patients, but the true figure is unknown (2). Spontaneous regression of colon cancer seems to be particularly rare
https://academic.oup.com/jjco/article/45/1/111/888056
So using 0.0016% and 12 patients (which is what the paper the NYT actually links)
For a ~50% chance of seeing one trial with 12 patients have complete remission you'd expect to see ~43k trails.
(1 - 0.000016)^43000 = 0.502577
I wouldn't discount this study based off of those numbers.
(Tangentially I think your stats are a little messed up there - you calculated the expected number of people out of 43000 surviving, not the trials returning a false positive. Assuming 0.0016% that chance is astronomically small, so your argument is stronger.)
People who suffer from rectal cancer usually undergo surgery to remove the primary tumor. But those trial patients weren't operated on, their treatment was non-invasive.
How many rectal cancer sufferers who never undergo a surgery survive? I would bet that it is a lot less than 67 per cent.
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.
If that's what they mean the survival rate wouldn't be 67% so this would imply a 1349 in 1350 chance the treatment is better than the average treatment?
This looks much more like tossing a dice 18 times and getting a 6 every single time!
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