News coverage that doesn’t learn from the past is condemned to repeat it

It was more than 100 years ago when George Santayana wrote, “Those who cannot remember the past are condemned to repeat it.”

It was 1985 – 28 years ago – and Dr. Steven Rosenberg of the National Cancer Institute was a media darling with stories about his research on interleukin-2 for cancer.  Magazine covers, newspaper headlines, Today show appearance. Much of it hype. Newsweek put “The Search for a Cure” on its cover. An AP story included the cautionary quote: “Dr. Robert Mayer of the Dana-Farber Cancer Institute in Boston cautioned that although the research is worth pursuing, ‘I would be very reluctant to put it up in neon lights and call it a major advance.’ ”

Indeed, IL-2 has gone on to be tested in many trials. But even within a year of the 1985 splash, the news enthusiasm had dimmed.   We’re still searching for that cure.

And, 28 years later, we’re still putting immunotherapy research up in neon lights.  “Breaking Through Cancer’s Shield,” is the New York Times headline today.  Excerpt:

Still, researchers think they are seeing the start of a new era in cancer medicine.

“Amazing,” said Dr. Drew Pardoll, the immunotherapy research director at Johns Hopkins School of Medicine. This period will be viewed as an inflection point, he said, a moment in medical history when everything changed.

“A game-changer,” said Dr. Renier J. Brentjens, a leukemia specialist at Memorial Sloan-Kettering Cancer Center.

“A watershed moment,” said his colleague, Dr. Michel Sadelain. (Both say they have no financial interests in the new drugs; Dr. Pardoll says he holds patents involving some immunotherapy drugs, but not the ones mentioned in this article.)

Researchers and companies say they are only beginning to explore the new immunotherapies and develop others to attack cancers, like prostate, that seem to use different molecules to evade immune attacks. They are at the earliest stages of combining immunotherapies with other treatments in a bid to improve results.

“I want to be very careful that we do not overhype and raise patients’ expectations so high that we can never meet them,” said Dr. Alise Reicin, a vice president at Merck for research and development.

But the companies have an incentive to speed development of the drugs. They are expected to be expensive, and the demand huge. Delays of even a few months mean a huge loss of potential income.

I am struck by the similarities between the Rosenberg news coverage 28 years ago and this story today.

Cost as an obstacle:

• Then: ”It’s clearly very novel,” said Dr. James Meir of New England Medical Center in Boston. ”The only concern I think the public should have is the incredible expense. You’re talking about tens of thousands of dollars to treat even one patient. That dwarfs the cost of any kind of conventional therapy.”
• Now: “a high price tag — $120,000 for a course of therapy” of one approved drug.

The novelty of the approach:

• Then: ”represents the first new kind of approach to cancer in perhaps 20 or 30 years.”
• Now: “researchers think they are seeing the start of a new era in cancer medicine.”

Anecdotes of seemingly incredible progress in a few seriously ill people:

• Then: “The treatments had caused tumors to regress in 11 of 25 patients with the most intractable, advanced cancers of the lung, colon, and kidney, and with melanoma, a skin malignancy.”
• Now: “His cancer disappeared on scans and has not returned, even though he has had no treatment for a year. …Three…patients had similar responses, including one who was treated five years ago in the first study. All, with advanced disease, would have been dead by now, he said, adding, ‘I have never seen anything like this, personally.’ “

This post is not a severe criticism of the New York Times story.  It was a story about fascinating research.

It is just the call from an old health care journalist to breathe deeply.  We have been here – at these watershed moments – before.  And it wouldn’t hurt to reflect on that more openly and more directly in our news stories as we put “amazing…game-changer…watershed moment” up high in our stories.

Santayana also wrote:

“The line between what is known scientifically and what has to be assumed in order to support knowledge is impossible to draw. Memory itself is an internal rumour; and when to this hearsay within the mind we add the falsified echoes that reach us from others, we have but a shifting and unseizable basis to build upon. The picture we frame of the past changes continually and grows every day less similar to the original experience which it purports to describe.”

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