Health News Review

The following is a guest post by Harold DeMonaco, MS, one of our expert reviewers on HealthNewsReview.org, and a frequent guest blogger on this site.

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The American Society of Clinical Oncology (ASCO) will hold its annual meeting starting on May 31st in Chicago, Illinois.  While we have consistently cautioned against over reading the abstracts and presentations made at the meeting, it appears that our admonitions are falling on deaf ears.

ASCO has once again provided access to the abstracts to be presented at its meeting weeks before the meeting will be held.  Some journalists have already picked up on several stories with their usual zeal.  Here’s a sampling:

Melanoma treatment uses immune system to kill cancer cells

NBC Nightly News reported on “very encouraging news in the fight against cancer. Specifically here, melanoma.” NBC’s Chief Science Correspondent Robert Bazell said that in a new study, researchers “combined Yervoy [ipilimumab] with a second experimental drug that hits a different target on t-cells allowing them to kill more cancer.”

As you read through the story, you will quickly come across the following statement:

“In the new study, some 40 percent of patients in the study saw reduction in their huge tumors from the treatment, which combines a drug called ipilimumab and an experimental new immunotherapy known as Nivolumab.”

Sounds pretty good.  But now look at the abstract. Remember, though, that the abstract findings have not been presented yet and have not been subject to peer review. The abstract was discussed in a news conference 16 days  ahead of the start of the ASCO annual meeting. This was a phase 1 study in a total of 69 subjects.  The abstract is reporting on a sub sample of 37 subjects who have completed the trial and have been followed for 12 weeks.  Eleven of the 37 subjects had a >80% reduction in tumor volume at 12 weeks.

Newspapers and web publishers have also jumped on some of these early release abstracts and company press releases.  The Wall Street Journal provides its readers with a story about the abstract as does Medscape and Bloomberg News.  We are treated with headlines that include, Truly remarkable…. “…drug cocktail stymies melanoma,” and “…drugs harness the power of the immune system.”

Come on! This was a phase 1 study and only reports on a little more than half the participants’ results at 12 weeks.

Some news sources, such as the New York Times, mixed enthusiasm with some caution, such as: “The studies are small and they did not compare the drugs with a placebo or with another treatment, and it is unclear if they will lengthen lives. Moreover, it is unclear how long the effects will last, though there are signs that for many patients, it could be a year or more.” But the mix – in some stories – was imbalanced.  NBC said there were some caveats, listed some, but then concluded: “Despite those limitations, immunotherapy is an exciting new concept. Experts say it stands a very good chance of curing many patients whose cancer would have been fatal.”  (Note: immunotherapy is not a new concept.  And we’re always troubled by the vague term cure.)

I suspect the media feeding frenzy has just begun and we will be blessed with other selected stories from this year’s ASCO session.  I can only speculate on the reasons for ASCO to release the abstracts so far in advance of the conference.  One reason may be to provide its members with material prior to the session so that they can make better use of their time at the meeting.  Other reasons I can think of are perhaps not quite so benign.

I understand that the media must turn a profit to survive and profit is directly related to reader/viewership.  Headlines have the power to grab the reader and viewer and the more important the headline sounds the more likely it is that the reader/viewer will continue.  But shouldn’t the reporting be a bit more reality based?  How is the public served with over the top headlines and incomplete reporting?

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Publisher’s addendum on May 21:  The melanoma abstract was one of just seven highlighted by ASCO news releases in an ASCO “presscast” on May 15.  That’s seven out of more than 4,500 posted in advance of the ASCO meeting.  Who decides which seven are most important to get this kind of attention?  How do they decide?  Important questions – since we can see the influence and impact the decisions have on journalists, and, therefore, on the public

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Comments

Greg Pawelski posted on May 18, 2013 at 3:42 pm

As opposed to the more clinical American Society of Clinical Oncology (ASCO) trade show, basic scientists attend the American Association for Cancer Research (AACR) meeting which was held April 6-10 in Washington, D.C., which provides a scientific perspective on oncologic developments. The AACR conference affords investigators the opportunity to discuss their basic research and to present methodology workshops. Their meeting also provides an early overview of the general direction that cancer research will be taking over the coming years, while ASCO reports what they’ve recently done.

One of the laboratory oncologists in attendance described several overarching themes at the AACR meeting, the most prominent of these being the remarkable strides in immunologic therapy. Numerous investigators reported novel developments in the field. Where the immune system used to present as an insurmountable barrier of complexity, today we have dissected specific response elements and immune suppressive pathways that offer unique opportunities for therapy. Immunologic therapeutic are now specializing into sub-domains.

One productive area reflects de-repression. The most mature example being Yervoy (ipilimumab), the monoclonal directed against CTLA-4. This broadly expressed T-cell repressor molecule can be de-repressed resulting in significant anti-tumor activity, but with moderate to severe toxicity. The inhibition of PDL-1 is more selective and therefore less toxic, it has provided responses in melanoma, NSCLC and other diseases. Among the most striking observations in this field is the role of the human immune system and the tumor microenvironment in tumor promotion. Immunologists are rapidly learning that cancer is much more than just cancer cells.

Is this the kind of hype we are going to hear from the ASCO trade show? Just give us the science!