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The news release focuses on a study published in Nature Chemistry Jan. 8, which found that a compound called JPC11, found in stinging nettle plants and ants, is effective at attacking some kinds of cancer cells. However, while the release explains how JPC11 can attack cancer cells, it does not tell readers of the many hurdles that lie between the current discovery and any possible future use of the compound to fight cancer in humans. The research published in Nature Chemistry reflects only work done testing JPC11 against some types of cancer cells in vitro. In other words, JPC11 has not yet been tested in an animal model, much less begun the lengthy process of clinical trials that are necessary to determine whether it may be used on a large scale by human patients.
The release acknowledges in a quote from a lead researcher that “It will take time to progress from the lab to the clinic” but the caution seems weak in comparison to the claims and speculation made elsewhere in the release, including in the headline.
While estimates can vary, most agree that it takes more than a decade to move a new drug from the laboratory to clinical practice — as well as research funding that is estimated to range from hundreds of millions to billions of dollars. Given that JPC11 has yet to be tested in animals (or, at least, those tests are not yet published), it will be a long time before it could be used to treat cancer patients. And there is the very real possibility that it will never be used to treat cancer patients. Most potential pharmaceutical treatments wash out during animal testing or clinical trials. It’s important for releases on anti-cancer research to be clear on where potential new treatments are in the development process. This release does not do that.
Given how early this research is in the development process, it would be impossible to place a specific cost on the potential treatment — or even a range of costs. However, the release could tell readers whether the process used to make JPC11 is expensive, time-consuming, relies on novel technologies, or has the potential to be easily scaled up — all of which can affect ultimate cost. For example, if it’s a relatively straight-forward process that does not rely on specialized equipment or high-cost components, that’s worth mentioning. If it’s a complex, multi-step process that relies on highly-processed (and expensive) ingredients or technologies, that’s worth mentioning too. The release doesn’t address potential issues related to cost.
The release doesn’t adequately explain the limitations of the in vitro model and that it remains unclear how the compound would perform in human studies.
The release does not tell readers how effective JPC11 was at attacking cancer cells during in vitro testing. How effective was it at killing cancer cells, or preventing cancer cells from multiplying? For that matter, the release does not tell readers what types of cancer cells were used in the testing. While the release does mention that “researchers have been focusing on the potential to use this compound on ovarian and prostate cancers,” it’s not clear whether those cancers were the subject of this particular paper. More on this under the section on Quality of Evidence.
The release notes that “the development opens up a possibility for a more selective cancer treatment as JPC11 was observed to specifically target the biochemistry of cancer cells, leaving healthy cells largely untouched” (emphasis added). What does “largely untouched” mean? Was there some level of harm or change induced in healthy cells? In the context of human health, vague statements like that make us nervous. That’s particularly true when a release does not disclose what sort of testing has been done — and remains to be done — for a potential treatment. It’s always a good idea to point out that in research this preliminary, we have almost no idea what kind of adverse effects might occur when the compound is actually administered to patients.
This also plays to the popularity of terms like “precision oncology” and “selective’ or “targeted” cancer treatment.” We are finding more and more that lots of our targeted treatments still can and do have “off target” harms. Gleevec and subsequent generation molecules are examples (prototypes) of great “targeted therapies” but they still have other common side effects. Also, always comparing targeted molecules to chemotherapy is becoming less fair these days given that we have a better understanding of how to anticipate and manage side effects in general.
Based on the paper, we can tell you that in vitro tests were performed, but the release doesn’t give readers even that much information. What sort of tests were performed? What were the researchers evaluating? How were they evaluating those things? We don’t necessarily expect a news release to go into all of the technical details, but in this case the study is simply not described. That makes it impossible to assess the quality of the evidence.
Taking a look at the methods, this research team does all of the requisite pre-clinical work one would expect prior to moving into animal models. The standard benchmarks were met, which is why it was worthy of publication. This could have then been put into context as research that faces a long road to clinical trial but in the end, the release does not do the work justice.
The release notes the sources of funding for the study. The release does not explicitly state that there are no conflicts of interests, but there do not appear to be competing interests here.
The release refers to alternatives, but does not really compare them. For example, it notes that ovarian cancers are becoming more resistant to drugs such as cisplatin. The release also refers to unspecified adverse health effects associated with other anti-cancer drugs. However, this is not enough to earn a satisfactory rating here. To compare apples to apples, it would be useful to know whether JPC11 is at least as effective as any of these other drugs in in vitro testing. Again, the fact that JPC11 is in the earliest stages of development makes a comparison difficult, but there should be some attempt to address the issue in a meaningful way or, at the very least, to make clear to readers that JPC11 is in the earliest stages of development.
At the beginning of the 14th paragraph, the release notes that “It will take time [for JPC11] to progress from the lab to the clinic.” Those are the only words that tell readers anything about where JPC11 is in the development process. The release does not tell readers what has been accomplished (some in vitro testing), what is next, what hurdles lie beyond that, or anything else pertaining to how long it may take for this to develop into a useful clinical tool. And there is no acknowledgment that it may never become a practical treatment.
The release clearly articulates JPC11’s mechanism for action for affecting cancer cells, as well as why and how that is novel.
The problems with this release lie in what it does not say. There is nothing wrong with the language used here. For example, the release states that “cancer cells can be destroyed more effectively and selectively…” but it doesn’t give readers crucial information. For example, the release says JPC11 is “more effective” at destroying cancer cells. More effective than what? How much more effective? What sort of cancer cells were tested? Any time one says Thing A is “more effective” or “better” or “safer” or whatever, there has to be a Thing B. This release doesn’t do that. It’s not that the release makes outrageous claims, there’s just a complete lack of context for the information that’s there. That makes the release virtually useless for readers.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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