6 things to keep in mind if you read cancer-related news in the next few days

Today kicks off the annual meeting of the American Society of Clinical Oncology, the world’s largest cancer research conference, which is taking place in Chicago and runs through Monday.

In the next few days, if you read any news stories about cancer treatment, there’s a good chance those stories originated at ASCO’s meeting. 

The media relations team at ASCO plays a big part in determining what gets reported, and how. As they do every year, the media team put about 20 research abstracts under a media embargo, meaning that news outlets are forbidden to report on the study details until the embargo lifts during the conference. It’s these late-breaking studies that will likely generate the most headlines–and we’ll be writing more blog posts over the next few days to see how these abstracts (and other cancer stories) get reported and framed by journalists.

Some good news: We were pleased to see that this year, ASCO has chosen to spend today–the first day–releasing abstracts on interventions intended to improve quality of life, with a focus on mental health interventions. We hope news outlets jump on these, as they are very real and often ignored concerns for cancer patients and their loved ones.

But for the most part, the embargoed abstracts focus on clinical trials involving new tests and pharmaceutical treatments, especially immunotherapy, which has exploded in popularity as a research topic in the past year:

765 immunotherapy combination trials in April, up from 215 in November 2015 https://t.co/QuLp7kRtRl

— Jonathan Rockoff (@jonathanrockoff) June 1, 2017

There are also some studies on genomic screening and so-called “liquid biopsies” as well. These are all new and emerging therapies–with a lot of pharma money invested in them– so the potential for hype from investigators and misinterpretation by journalists is high.

With that in mind, we’ve pulled together a list of things to keep in mind as you read cancer treatment news over the next few days.

1. These are mostly unpublished, preliminary results.
Abstracts that are released at a major medical conference are snippets of studies that usually have not been peer-reviewed nor published in medical journals. They should be approached with great caution. Without reading through the full details of a study, it’s impossible to know important limitations, such as a high drop-out rate among the treatment group. We also can’t see the list of adverse events. Many studies presented as meeting abstracts may never even get published in a journal.

2. Some of the studies are small and not designed to prove benefits.
This doesn’t mean they aren’t rigorously conducted studies, but they are designed mainly to show safety; indications of benefit are unreliable and must be confirmed in larger studies. Regardless, it’s common for news outlets to write about these studies anyway–and sometimes misstate the findings. Here are a few resources that will help you think and write about these kinds of studies more accurately:

• Why you should back away slowly from case studies
  
• Why we should all be wary when PR machines promote phase 2 studies
• Our full toolkit of tips for understanding studies

3. Immunotherapy drugs–and the overlapping field of precision medicine–are not as awesome as news stories tend to make them out to be.
Case in point: Just yesterday we gave two out of five stars to the Los Angeles Times for its coverage of the immunotherapy drug Keytruda. The drug received FDA approval for use on tumors that display specific genetic markers (which is known as precision medicine). Our reviewers noted that the story “overlooks life threatening risks, overstates the meaning of trial results, inaccurately describes the patients who are covered by the FDA action and neglects the disappointing track record of drug approvals based on surrogate endpoints, rather than real measures of survival or quality of life.” This isn’t unique to the Times–we’ve seen this problem so often that we’ve put together several resources to help journalists and the general public better understand the full impacts of immunotherapy:

• 6 tips for writing accurately about cancer immunotherapy drugs
  
• How to report accurately about the harms, side effects and risks of immunotherapy
  
• Can immunotherapy actually trigger cancer? A look at emerging research

4. “Liquid biopsies” also tend to get uncritical news coverage. As we pointed out during last year’s ASCO conference, there are lots of unknowns about this emerging approach to cancer diagnosis. Even as the evidence grows, keep in mind it’s unlikely to work for all cancer. As one source said in a news story, “there are simply tumors that do not shed DNA into circulation at detectable levels, so we are bound to miss them.”

5. Ask yourself: What were the “endpoints” of the study?
It’s important to look at what, exactly, the study was measuring as an outcome–aka, the endpoints. Ideally, we want to know if a new cancer intervention does one of two things: improve survival or quality of life. But researchers can’t or won’t always measure those outcomes, and instead measure “surrogate endpoints”–things like tumor shrinkage, or the length of time until the disease progresses. Either of these sound like good things, but ultimately they cannot and do not prove that a patient using the new treatment will live a longer, better life than patients using standard treatments. (See tip #2 of this post for more.)

6. Don’t forget the extremely steep price tag.
We’ll keep this last one short but sweet: Some of the world’s most expensive medications are cancer drugs, yet in many cases, there is little evidence that the cost is worth the (minimal) benefit.

As oncologist Vinay Prasad said in a podcast with us, when it comes to the cost of cancer drugs: “It’s horrendous, unjustified and not based on any rational considerations.”