This is a solid report on a controversy over potential risks of heart failure associated with a class of commonly used breast cancer chemotherapy drugs called anthracyclines. The reporter draws on a variety of sources and provides differing perspectives about risks and benefits.
However, the story is really about new understanding of which subgroups benefit from anthracyclines, not that they "work no better" than other drugs.
The article would have been stronger if it had included statistics about how effective the various cancer drugs were.
The story is made weaker, not stronger, by the anecdote at the end. The woman interviewed was an overweight smoker at elevated risk for heart disease, and we don’t know enough about her treatment to know whether anthracyclines had anything to do with her heart problems or recovery. This is at best confusing, at worst misleading.
The article does not report how much the drugs costs, but the price is not necessary or useful in this story. The issues with both treatment and side effects are literally life and death. The relative cost of the drugs is not an issue.
While the report states that the controversy is triggered by new research suggesting anthracyclines "work no better" than less risky drugs, it does not compare efficacy of the treatments directly.
The article does report that only around 8 percent of breast cancer patients would get unique benefit from the drug. This is useful, but it is not proof that anthracyclines "work no better" than the alternatives.
The story is quite clear about the nature and size of the drugs’ risks.
The reporter cites a credible source’s analysis of nine studies that shows only 20 percent of breast cancer patients with an overactive Her2 gene respond to anthracyclines, and only 8 percent of the group gets special benefit from the drugs. (Although the reporter could have noted that the source is NOT a disinterested party – since he is discussing the findings from some of his own research.)
The report also cites a new Journal of Clinical Oncology study that shows people who had taken anthracyclines were 26 percent more likely to have developed heart failure in the following decade. The report provides sufficient detail about the study’s methodology.
The article does nothing to exaggerate the seriousness of breast cancer or heart failure, nor does it exaggerate the benefits of chemotherapy with anthracyclines or other drugs.
The report quotes three credible sources–two researchers and one clinician. They do not appear to have conflicts of interest.
The recent study described is from a peer-reviewed journal.
The article does a decent job of indicating that other chemo drugs are available. It would be useful to know a bit more about how many alternatives there are and how widely they are used.
The article states that anthracyclines are a "mainstay" and a "staple" of chemotherapy for breast cancer. While this makes clear that the drugs are widely available, it would have been useful to know what percentage of chemo patients get these drugs compared to others.
The story implies the side effect issue is novel, while in fact the heart-related side effects of these drugs are well-known.
There is no evidence that the article draws on a press release.
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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