Advancing New Therapies: Dr. Alison Schram on the Power of Clinical Trials

When Ann Rerat first noticed uncharacteristic uterine bleeding, she knew something wasn’t right. What began as a routine medical concern quickly escalated into a life-altering diagnosis: a rare and aggressive uterine cancer. After undergoing a hysterectomy, she sought a second opinion at Memorial Sloan Kettering Cancer Center, where she learned the disease had spread—and after being treated with chemotherapy, it continued to grow. 

At MSK, she came under the care of Dr. Alison Schram, a gynecologic medical oncologist who specializes in developing and testing new therapies through clinical research. Dr. Schram leads clinical trials that test innovative new treatments, often offering options when standard approaches fall short. 

With Ann’s cancer continuing to progress, she was presented with two paths forward: conventional chemotherapy or enrollment in a clinical trial testing a new targeted approach. Ann chose the trial. Over time, her cancer shrunk and ultimately disappeared. “It was nothing short of a miracle,” she says. 

Stories like Ann’s are at the heart of Finding Tomorrow’s Treatments Today, The Society of MSK’s campaign highlighting how philanthropic support fuels the trials that drive cancer breakthroughs. Supported by The Society, MSK physicians like Dr. Schram are able to move promising therapies from the lab to patients faster. “Clinical trials are how we develop new and better therapies,” she says. “All standard treatments were once tested in a clinical trial first.”   

Below, Dr. Schram shares more about her path to this work, the science behind Ann’s trial, and why clinical trials remain essential to advancing cancer care. 

I have always been fascinated by genetics and biology. After losing a friend to cancer ata young age, I resolved to be an oncologist working to improve treatments. When I discovered early-phase clinical trials, I knew it was the perfect field for me. I chose gynecological cancers as my expertise because many are serious yet treatable, and I saw an opportunity to develop more targeted, effective therapies for these patients.

Ann enrolled in a clinical trial testing a combination of two drugs: a PARP inhibitor and immunotherapy. The PARP inhibitor was hypothesized to block DNA repair in cancer cells, while the immunotherapy was hypothesized to help the immune system recognize and eliminate those damaged cells. Although she had a rare cancer with limited treatment options, the trial was open to patients with a BRCA mutation regardless of tumor type. 

Her cancer had not been responding to prior treatment, and her prognosis was poor. Genetic testing and enrollment in the trial changed the course of her disease—she has now been cancer-free for many years. Her case also provided important insights into how BRCA2-altered uterine leiomyosarcoma may respond to targeted therapy, helping expand options for others with this diagnosis. 

I often hear patients say they don’t want to be a “guinea pig,” and I understand that hesitation, but the studies we open are based on strong scientific rationale. I only enroll patients when I believe the potential benefits outweigh the risks.

There has been incredible progress in gynecologic cancer treatment in recent years. We’re seeing therapies that deliver chemotherapy directly to tumors, immunotherapies that can, in some cases, cure metastatic disease, and targeted therapies that exploit molecular vulnerabilities in tumors. Our goal is to make cancer a chronic, manageable condition—or cure it altogether—and I believe we’re well on our way.

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