This news release reports results of a retrospective study comparing conventional radiotherapy for inoperable pancreatic cancer versus an adaptive radiation therapy that allows clinicians to see the tumor in real time and respond to changes on a daily basis. Targeting the tumor more specifically means higher doses of radiation can be used without increasing damage to surrounding tissues. The study, funded by ViewRay, maker of the MRIdian system, is admittedly preliminary. It is to be followed up by a clinical trial.
The release would have been more helpful to readers had it mentioned costs and disclosed a conflict of interest between one of the study authors and the device manufacturer.
Surgery is an option only for certain less common types of pancreatic cancer. The five-year survival rates for pancreatic cancers that cannot be treated with surgery are 12% to 14% even for those diagnosed in stage I; the five-year survival rate for cancers detected at stage IV is about 1%, according to the American Cancer Society. ACS reminds readers that five-year survival rates are estimates and that “many people live longer – often much longer – than 5 years.”
In that context, a treatment that could extend the lives of the 1.5% of Americans who develop pancreatic cancer is big news.
Costs of the MRIdian on-table adaptive radiotherapy in comparison to conventional radiotherapy are not discussed. Given that it is new and more personalized than current treatment options it’s likely to be correspondingly more expensive. Certainly, more frequent MRIs would be very costly.
The release provides exact information about increased survival rates in the cohorts of individuals treated with the adaptive versus the convention radiotherapy techniques.
“The cohort receiving a higher dose demonstrated a near doubling of median overall survival (Kaplan-Meier estimated median overall survival of 27.8 months compared to 14.8 months).”
The news release provides specific results regarding experiences of both groups with regard to toxicity from radiotherapy.
We appreciate that the headline of this release starts with the words “early data” because this report deals with preliminary and retrospective research. It was not a clinical trial. Instead, results are based on retrospectively comparing treatment of two groups of patients at four institutions. Respective comparisons can’t account for a host of factors that might influence results. At the end of the news release readers are told that on the basis of these promising results a clinical trial is being planned.
With five-year survival rates of 1 to 14%, it would be hard to engage in disease mongering about pancreatic cancer.
This research was sponsored by ViewRay, the company that developed the MRIdian system, and the release does a good job calling attention to this. However, according to the published study, at least one of the co-authors received honoraria from ViewRay Medical Systems. Since this was not included in the release we’re rating this criteria Not Satisfactory.
This study was all about comparing alternatives, so it scores Satisfactory on that criterion. It would have helped readers if alternatives would have been described more in laymen’s terms.
The news release notes that the next step is a prospective clinical trial and that tells savvy readers that this treatment strategy has a long road of testing ahead. Still, we think the release could have done a better job clarifying that this therapy is not yet ready for patients, outside of the clinical trial.
A study that suggests a doubling of median survival is sure to capture the attention of patients newly diagnosed with pancreatic cancer. These patients and their families are closely aware of the glum statistics for the disease. This is a practical concern that the release should have touched on.
This technology is indeed novel and unique to ViewRay, though it is becoming available in more and more cancer treatment centers.
No unjustifiable language was identified in the news release.