This concise report (524 words) relates in simple terms the apparent success of a complex immunotherapy in treating a single patient with metastatic melanoma. The story shows how a single case study such as this can illuminate advances in therapy for often-incurable diseases, and is careful to point out that the research is very preliminary. The story seems to have tried to be sure the reader did NOT go away with the impression that this experimental approach was ready for prime time. It is very difficult to communicate this science as this story tried to do.
But we criticize the use of the term "cure" in the opening sentence. And the story did let Dr. Rosenberg discuss unpublished data, which may glorify positive results when we don’t know the whole picture yet. Another major oversight is that the story does not mention any of the potential harms of treatment, which can include devastating infections and a flu-like syndrome. Readers would probably also benefit from a brief note about the limitations of case series, explaining why they can’t account for all of the factors that might explain a “positive” outcome in a handful of individuals. Finally, the story did not include any independent perspective, since both experts interviewed are involved in this line of research.
The story says the cost is roughly $30,000 to $50,000.
The story relates the benefits of immunotherapy reported in a published, New England Journal of Medicine study in simple, absolute terms—complete remission from a late-stage cancer that “has stayed away for more than two years.” It also uses a loaded term–"cured"—to describe this remission. However, it is not yet known if this man is "cured." And if the man has been lost to follow-up, as another news report suggests, we may never know. The story’s reporting of unpublished data by Dr. Rosenberg is also incomplete, stating only that "52 of 93 patients experienced a positive result." What does "positive result" mean?
The story does not mention potential harms of the immunotherapy it describes. Immunotherapy frequently causes a flu-like syndrome. Among the potential complication are devastating infections. The published case study hints at these, observing that the patient’s initial reaction to the therapy was “transient lymphopenia, low-grade fever, and myalgia.” Other adverse events commonly reported after immunotherapy include diarrhea, rash, adrenal insufficiency, and liver test abnormalities.
The news report is careful to point out that this is a case study of a single individual with metastatic melanoma, and as such the results are suggestive and hopeful but very preliminary. However, it could have provided more information about the drawbacks of case reports in general and of this case report in particular–pointing out, for example, that they can’t account for all of the factors that might explain a “positive” outcome in a handful of individuals. In the Seattle research, why did the other 8 fail treatment? Perhaps there were other factors, not the immunotherapy, involved in the positive outcome experienced by this one patient. Where is this patient now? In another news story, Dr. Yee reports that the patient has been lost to follow-up at 2-years. But the story’s first line said he was "cured." This is a loaded term, and it is not yet known if this man is "cured" and may never be known if he is lost to follow-up.
The story shows how a single case study such as this can illuminate advances in therapy for often-incurable diseases, but it does not overstate the importance of late-stage melanoma or prey on fears.
The article quotes two scientists—the lead researcher on the published paper and the chief surgeon at the National Cancer Institute, an investigator involved in another study that the news story mentioned. Neither is an independent source.
The story notes that the person undergoing the new immunotherapy failed to improve with chemotherapy, though it does not mention tumor excision or radiation as other potential therapies. And one wonders whether the prior chemotherapy played a role in the one Seattle patient’s remission.
The news story explains that the therapy it describes is not widely available, and probably won’t be mainstream for another 5-10 years. However, the story does not say whether the therapy is FDA-approved. Numerous immunotherapies have been approved for various cancers, but this treatment for melanoma does not appear to be among them.
The story does a nice job of placing this story in its historical context, explaining that the new therapy comes out of the field of "adoptive immunotherapy," which has evolved over the course of some 30 years.
It does not appear that the story relied solely or largely on a news 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
Comments
Please note, comments are no longer published through this website. All previously made comments are still archived and available for viewing through select posts.
Our Comments Policy
But before leaving a comment, please review these notes about our policy.
You are responsible for any comments you leave on this site.
This site is primarily a forum for discussion about the quality (or lack thereof) in journalism or other media messages (advertising, marketing, public relations, medical journals, etc.) It is not intended to be a forum for definitive discussions about medicine or science.
We will delete comments that include personal attacks, unfounded allegations, unverified claims, product pitches, profanity or any from anyone who does not list a full name and a functioning email address. We will also end any thread of repetitive comments. We don”t give medical advice so we won”t respond to questions asking for it.
We don”t have sufficient staffing to contact each commenter who left such a message. If you have a question about why your comment was edited or removed, you can email us at feedback@healthnewsreview.org.
There has been a recent burst of attention to troubles with many comments left on science and science news/communication websites. Read “Online science comments: trolls, trash and treasure.”
The authors of the Retraction Watch comments policy urge commenters:
We”re also concerned about anonymous comments. We ask that all commenters leave their full name and provide an actual email address in case we feel we need to contact them. We may delete any comment left by someone who does not leave their name and a legitimate email address.
And, as noted, product pitches of any sort – pushing treatments, tests, products, procedures, physicians, medical centers, books, websites – are likely to be deleted. We don”t accept advertising on this site and are not going to give it away free.
The ability to leave comments expires after a certain period of time. So you may find that you’re unable to leave a comment on an article that is more than a few months old.
You might also like