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 Rosenberg discuss unpublished data, which may glorify positive results when we don’t know the whole picture yet.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 The story’s reporting of unpublished data by Dr.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
Puleeeeease... this 'game changer' weight loss drug causes more nausea and vomiting than a placebo. Some game, some change. My friend Gary would spank you for using the eighth word medical reporters should never, ever use. @garyschwitzer @thackerpd
https://www.healthnewsreview.org/toolkit/just-journalists-writing-tips-case-studies/7-words-and-more-you-shouldnt-use-in-medical-news/ https://twitter.com/OttawaCitizen/status/1361426796126830597
A scary @statnews Op-Ed warns that govt attempts to rein in Pharma may cut off access to "life-changing" drugs.
It takes @garyschwitzer to let us know: the author spent 10 years as Pfizer's public-policy chief. https://twitter.com/garyschwitzer/status/1360325022578053123
.@TranspariMED criticizes STAT op-ed for not disclosing pharma funding of author’s institute - similar to criticism we’ve made of STAT op-eds in the past. @transparify @ThinkTankWatch @icer_review https://www.healthnewsreview.org/2021/02/transparency-watchdog-criticizes-stats-non-disclosure-on-pro-pharma-op-ed/
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