Health News Review

Key quote found too late in the story: “Until the vaccine is linked to an actual survival benefit or improvement in tumor status, no one can say if it helps patients in a meaningful way.”

Our Review Summary

The current article discussed some very preliminary results of an experimental vaccine for HER-2 breast cancer.

Our key concerns:

  • The race to report on data that hadn’t even been formally presented at a scientific conference.
  • The race to declare in the headline that the vaccine “might work” when, indeed, as the independent expert quoted in the story pointed out, we know nothing about survival benefit or even improvement in tumor status at this point.

A better explanation of what type of response the subjects in the study experienced may have helped to better frame the findings.


Why This Matters

There are several breast cancer vaccine trials underway with a significant amount of time and money invested. Before stories start to appear hinting that any of these vaccines “might work,” more concrete evidence on more meaningful endpoints needs to be found.


Criteria

Not Applicable

Does the story adequately discuss the costs of the intervention?

Not Applicable

Costs weren’t discussed, but since this was an early report on an experimental vaccine, that is understandable.

Not Satisfactory

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

The article was vague in describing the results and did not elaborate on what the response was that those in the vaccinated group exhibited:

“The investigators found that in the vaccinated group, 86 percent of patients showed a significant response, compared with 27 percent of those in the “control” group who did not get the injection.”

To its credit, the story included important caveats: the subhead of the story said “true significance unknown” and later in the story was this independent expert’s quote, “Whether it actually has an increase in survival remains to be seen.”

But the vagueness on the main finding of the study leads us to give this an unsatisfactory score. What does “significant response” mean?

Not Satisfactory

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

The study did not discuss any potential side effects of the current vaccine.

Satisfactory

Does the story seem to grasp the quality of the evidence?

Satisfactory

The saving grace in the article was the quote from a researcher at City of Hope Comprehensive Cancer Center who cautioned about drawing conclusions from the preliminary results:

“But until the vaccine is linked to an actual survival benefit or improvement in tumor status, Diamond said, no one can say if it helps the patients in a meaningful way.”

This is an important point since, according to the article, the significant finding is that those who received the vaccine had a “response” and a decrease in cells that suppress the immune system.  Neither of these points really shows that the vaccine may actually work.

Satisfactory

Does the story commit disease-mongering?

Satisfactory

There was no disease-mongering of HER2-positive breast cancers.

Satisfactory

Does the story use independent sources and identify conflicts of interest?

Satisfactory

The article contained quotes from a different researcher who was very cautious about drawing conclusions from the current study’s findings.

We do wonder,  though, what it means when the story says that the independent expert “reviewed the findings.”  What did he review?  Since the researcher’s findings hadn’t even been presented yet when the story was written, did the independent observer review the short abstract that appeared in the conference program?  Did he have access to a more complete data set or a more complete description of the work?

Satisfactory

Does the story compare the new approach with existing alternatives?

Satisfactory

Barely satisfactory – the story at least mentioned that “Numerous vaccines to prevent breast cancer recurrence are currently under study.”

Satisfactory

Does the story establish the availability of the treatment/test/product/procedure?

Satisfactory

The story stated ” it will take at least five years before the vaccine could conceivably be available if ongoing studies bear out.”

Not Satisfactory

Does the story establish the true novelty of the approach?

Not Satisfactory

The story stated that “Numerous vaccines to prevent breast cancer recurrence are currently under study” but didn’t explain how the vaccine in question is different than any of those other approaches.

Satisfactory

Does the story appear to rely solely or largely on a news release?

Satisfactory

The article does not appear to be based solely on a press release.

Total Score: 6 of 9 Satisfactory


Comments

Pat Battaglia posted on April 9, 2012 at 10:25 am

The title of this piece indicates that a “breast cancer” vaccine is being developed. This vaccine targets HER2 positive tumors, which we find out midway through the article affect one in five of those diagnosed with breast cancer. As a survivor, I understand the complexity of the disease and that there is no one-size-fits-all approach to treatment. I would prefer that headline writers consider their readers intelligent enough to understand that fact and include a modifier such as “some breast cancers.” But then, a “preliminary study” about a vaccine that “might work” in “some cases” is hardly newsworthy.
The standard of treatment for those with a HER2 positive breast cancer diagnosis is the drug herceptin, which has a proven survival value. I am assuming that all the women included in the study have been or are being treated with this medication. Will this new vaccine produce any survival value beyond that which herceptin provides? As I understand it, five years is the standard time at which the survival rates are measured, although my own oncologist considers ten years to be a better measure. In any case, it seems to me that the three-year follow-up time on this study is not long enough to determine the survival value of this vaccine.
We need better treatments. We need hope for those who face this diagnosis or are affected by it.. It’s far too early to know whether this vaccine will provide either. Save the hopeful headlines for stories that fulfill that promise.

Reply

Rich Steffens posted on April 11, 2012 at 8:21 pm

” The race to report on data that hadn’t even been formally presented at a scientific conference.”

The article in question is about the data for AE37 her2 peptide vaccine in the adjuvant setting. Specifically, the article reports on the findings presented at the ACCR Annual Meeting held last week. Data for this Phase II has been reported at SABCS 2011 and ASCO 2011. This is the largest Phase II study ever conducted for a peptide based vaccine to treat early stage her2 breast cancers, and this is the fiesta peptide vaccine to show potency even in absence of an adjuvant stimulant. DSF data has been reported, although the study needs to progress further. The AACR held a press conference to discuss the vaccine, which was one day before the poster abstract was presented at this top industry event.

According to the National Cancer Institute, over 200,000 women in the U.S. are diagnosed with breast cancer annually. Of these women, about 75% test positive for HER2 (IHC 1+, 2+ or 3+). Only 25% of all breast cancer patients, those with HER2 3+ disease, are eligible for Herceptin® (trastuzumab; Roche-Genentech). AE37 targets the rest, as the vaccine is not hla restricted. The vaccine, if approved, would fill an unmet need. This is highly newsworthy, and worth following.

Reply

    Gary Schwitzer posted on April 11, 2012 at 8:43 pm

    Rich,

    Thanks for your note.

    We stand by what we wrote.

    The story stated: “She is set to present results of the study on Monday at the annual meeting of the American Association for Cancer Research in Chicago.” That clearly states that the story was written BEFORE the talk was even presented at the AACR meeting. We don’t believe that is sound journalistic practice. Unless the news conference provides a range of observations from independent experts unaffiliated with the research, that setting doesn’t promote independent vetting journalism as much as it does stenography.

    We also stand by our observation about the journalism:

    The saving grace in the article was the quote from a researcher at City of Hope Comprehensive Cancer Center who cautioned about drawing conclusions from the preliminary results:

    “But until the vaccine is linked to an actual survival benefit or improvement in tumor status, Diamond said, no one can say if it helps the patients in a meaningful way.”

    This is an important point since, according to the article, the significant finding is that those who received the vaccine had a “response” and a decrease in cells that suppress the immune system. Neither of these points really shows that the vaccine may actually work.

    And, one of our key concerns:

    The race to declare in the headline that the vaccine “might work” when, indeed, as the independent expert quoted in the story pointed out, we know nothing about survival benefit or even improvement in tumor status at this point.

    A better explanation of what type of response the subjects in the study experienced may have helped to better frame the findings.

    Finally, we didn’t question the newsworthiness of the story – only the presentation of the story we reviewed. Please note: we gave it a satisfactory grade on 6 of our 10 criteria. In so doing, we provided constructive criticism for how important research developments could be presented in a more meaningful way to a consumer audience.

    Reply

      Rich Steffens posted on April 11, 2012 at 9:24 pm

      Thanks, Gary. One issue is that we do have that further data, as noted in abstracts at recent meetings, and as detailed in peer review articles authored by Col George Peoples and Dr Elizabeth Mittendorf from the United States Military Cancer Institute. Also, while the press conference held by the AACR was one day before the public viewing of the current abstract, the information was also presented at this time to the press. I believe the author in question used information provided to Newswise, which was under embargo until the day her piece was published. I have written about the vaccines under study at the USMCI. All in all, your points are well done, and I enjoyed reading your analysis. Thanks.


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