How unexpected results can lead cancer research and treatment in new directions

Our Pedro Ramirez, M.D., caused a stir at the Society of Gynecologic Oncology’s annual meeting in March when he reported unexpected findings in his Phase III study comparing minimally invasive surgery to open surgery for early-stage cervical cancer. The trial had stopped signing up new patients early, because patients who underwent minimally invasive laparoscopic or robotic surgery for hysterectomy — rather than having open surgery — were nearly four times as likely to experience a cancer recurrence. Their mortality rates were higher, too, so it wasn’t safe to continue. “We were very surprised,” says Ramirez, noting that the finding contradicted prior data. Although the number of patients affected in the study was small (27 recurrences in 319 patients), the evidence was absolute. Two other studies, including one from MD Anderson, evaluating large national databases came to the same conclusion. “Hopefully, the gynecologic oncology community will accept the results of these three studies and stop doing the minimally invasive procedure for cervical cancer,” Ramirez says. “Physicians have a responsibility to discuss with their patients the need for open surgery.” Navigating the unexpected It’s rare – but not unheard of – for a clinical study to uncover an unexpected truth, says George Wilding, M.D., vice president for clinical and interdisciplinary research. He recalls when immunotherapy studies appeared to show that cancer was growing instead of shrinking. “The tumor is infiltrated by immune cells, making it appear as if it’s getting bigger,” he explains. With continued scientific research, immunologists like Jim Allison, Ph.D., ultimately unlocked secrets of the immune system, bringing cancer treatments such as checkpoint inhibitors and T-cell engineering into the...