Michael Joyce is a writer-producer with HealthNewsReview.org and tweets as @mlmjoyce
A 49-year-old Floridian named Judy Perkins with metastatic breast cancer, whose illness has progressed despite multiple trials of chemotherapy, goes into complete remission after being treated with immunotherapy by Steven Rosenberg, MD, PhD — whom CBS dubs “a pioneer in harnessing the immune system to fight cancer.”
Rosenberg is no stranger to the spotlight. He became a media darling in 1985 when his research on interleukin-2 generated mega-coverage best described as long on hype but short on scrutiny. What was then heralded as a “watershed moment” and possible “cure” (yes, that word was dangled repeatedly) gradually faded to just a moment.
The media frenzy repeated itself again in 2006 — this time when Rosenberg reported using another form of immunotherapy to bring about remission in two people with advanced melanoma. Heart-warming anecdotes of the fortunate two prevailed over the 15 patients who died.
This week Rosenberg was in the spotlight again. And again, reporters were more smitten than skeptical.
Let’s start with the most egregious coverage: this video segment by Dr. Jonathan LaPook, a chief medical correspondent at CBS:
It’s an anecdote. But that doesn’t stop LaPook — a physician — from calling this one woman’s result a “game changer” and confide with the show’s host that it “blew me away.”
Only 90% of the way through the evidence-challenged segment do we get this:
This type of immunotherapy is still in its infancy … BUT … Judy’s success could open the door to use this kind of treatment for other solid tumors.
See that big, bold BUT? I highlight it because it seems to be going around.
Here are some big “but’s” from the BBC coverage: ‘Remarkable’ therapy beats terminal breast cancer :
See the trend? Give an important caution BUT quickly trump it with a grandiose claim that is not supported by current evidence; a glowing, eye-catching, optimistic, and hopeful promise — as variously described in this single Guardian article :
Ground-breaking … remarkable … unprecedented … dramatic … miraculous … extremely promising … [and] the cusp of a major revolution
Legitimate caution — which by the way shows awareness of how science works and thoughtfulness towards those with cancer eager for new advances — looks more like this:
It’s interesting that the aforementioned Guardian article, despite its parade of hyped language, did balance the story with some of these cautions. The BBC story barely did so. And the CBS report was appalling in this regard.
Also, there is another caution that rarely makes its way to the general public. Oncologists have long been aware of a lucky few — dubbed “Exceptional or Super Responders” — who respond to a therapy that over 90% of other patients do not respond to. As mentioned in this 2015 research paper by oncologists Vinay Prasad and Andrae Vandross, it’s very hard to know if the exceptional response is because of the treatment given or because of some biological characteristic unique to the responder’s tumor. They add:
In addition, merely generating robust response rates may be no guarantee of an eventual improvement in overall survival … very few surrogate endpoints (such as response rate) have a strong correlation with overall survival in oncology.
The prospect of harnessing our own immune system to attack cancer cells is a compelling and worthwhile avenue of research.
But as it stands now there’s insufficient evidence to make statements regarding efficacy, safety, costs, or how these treatments stack up against existing therapies.
So, at issue here is NOT whether this research is worthwhile, but how journalists handle the “buts” that are inevitable, important, and invaluable.
The case report of Judy Perkins — as published in Nature Medicine as a “letter” — can be found here.
The associated news release from the National Cancer Institute/NIH is here.