This was a concise (only 430-word) story reporting on the outcomes of a recent study which compared outcomes for patients with lung cancer who had previously undergone platinum-based treatments and received either the oral medication Iressa or chemotherapy infusions. It shows how efficiently critical elements can be relayed by a thoughtful reporter: the skeleton of study design, the bias implied by the funding source, the results, along with the comments from experts.
While the piece did a good job describing the study it was reporting on, it could have done a better job of putting the study into the perspective about what is already known about the medication Iressa. And while the headline did the story a disservice in that this treatment is not appropriate for all persons with lung cancer, this was a generally informative piece that a reader with a previously treated lung cancer would find useful for initiating a conversation with their physician.
The story mentioned that the cost of this drug treatment was several thousand dollars a month and that this was higher than the costs of other treatments.
It would have been better to provide a more concrete estimate of costs (several thousand – does this mean 2,3 or 6 thousand?). The story might have included some information about additional costs that would be encountered with the comparison treatment such as the cost of intraveneous infusions, testing to evaluate side-effects, and other connected costs.
The story did a good job reporting the data comparing patient survival with Iressa as compared to individuals treated with IV chemotherapy. The story skimmed over the side effects; reducing the frequency of bothersome or life threatening side effects would seem to be an advantage. The story mentioned quality of life factors that appear to be better with Iressa but did not quantify the benefit observed. Borderline satisfactory.
The story listed the common side effects of the treatment though it failed to indicate the frequency with which these were seen. In addition, rather than than merely listing these, the story could have included some information about the severity of the side effects (i.e. bothersome vs. fatal).
The story provided information about the size of the study conducted, the nature of the patients that were enrolled, and that the drug company that markets the drug funded the study. The study was designed as a non-inferiority survival trial to compare this medication with docotaxel, a chemotherapy treatment often used in individuals who have lung cancer and have had platinum based treatment but who are experiencing a return of their cancer. (While the story did provide information about the survival outcomes, it also included information comparing side effects.)
The story ended with a comment from one of the interviewed clinicians about quality of life being better with Iressa. The story should have been clearer about the predetermined endpoint of the study (longevity) and should not have ended with less data driven information.
The story did not engage in overt disease mongering.
However the headline does not hint that the trial is not about first-line cancer treatment, rather just patients who have been treated previously with a platinum-based chemotherapy.
The story included quotes from two individuals identified as not being connected with the study reported upon but with relevant expertise.
The story provided information about two treatment options for individuals who have recurrence of a previously treated lung cancer. It did not provide information about the natural history of not undergoing additional treatment for this condition which is necessary for evaluating the relative merit of the two treatments discussed.
The story did not mention radiation and surgery which are both options for some limited cancers.
The story mentions that the medication Iressa (gefitinib) is sold in the United States but that its availability in Europe is limited.
The story presented the use of Iressa as a treatment of individuals with lung cancer who had previously been treated with a platinum-based regimen as though it was a novel application. However – this drug was approved by the FDA in 2003 for this purpose. While the results of study reported on are interesting, the story did not provide the reader with a realistic picture of about the novelty of this product.
Does not appear to rely on a press release.
Systematic, Criteria-Driven
The tale of two “negative” studies. Or, how spin is applied to make research findings look more impressive. A must read. https://johnmandrola.substack.com/p/the-tale-of-two-negative-studies
The @nytimes chose to interview one of the editors of the @AnnalsofIM (publisher of this paper) who "gushed with extraordinary glee: It’s huge! There are very few things that reduce your mortality by 30%."
Turns out coffee is not one of those few things despite all that glee. https://twitter.com/garyschwitzer/status/1533202075928215558
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