In this story we learn of one of the most important recent advances in the treatment of ovarian cancer. In a randomized trial, intraperitoneal (IP) chemotherapy extended survival by 16 months compared to standard chemotherapy in women with stage 3 ovarian cancer. It is such an important finding that, in a rare move, the National Cancer Institute issued a statement calling for a change in clinical practice. This AP story adequately represents the prevalence and seriousness of ovarian cancer. The story adequately presents the alternative treatment option (intravenous chemotherapy) and the advantages and disadvantages of the new approach. The clinical evidence is presented accurately (although they did not mention that this was a randomized trial) and the benefits of treatment are presented for both intravenous and intraperitoneal chemotherapy. The story is especially strong in frankly portraying the harms and side effects of treatment, which were so bad that most women in the study were not able to complete the full course of treatment. The author does present a second opinion from an independent source. However, the story did not explain whether or not this treatment is novel, how widely available it is (and, by extension, how many practicitioners are experienced administering the treatment), and the costs or cost-effectiveness. Another major limitation of the story is that they did not attempt to place this treatment within the context of the overall picture of ovarian cancer. This study involved women with stage 3 ovarian cancer. What percentage of ovarian cases does that represent? What does that mean for women who are more/less advanced? The story leaves the reader thinking this treatment would be used for any woman with ovarian cancer, when in reality, we don’t know if it could help women who are more or less advanced than the study population. Presumably it would not be appropriate for early stage disease given the toxicity of the treatment, but what about later stages (which represent a large portion of ovarian cancer patients)?
No mention of costs
The story quantifies the benefits in terms of
survival for both intravenous and intraperitoneal chemotherapy.
The story gives us balanced information on harms, including the
very serious side effects which led to less than half the study population adhering to the full course of chemo.
The story accurately represents the nature of the clinical evidence, that this was a controlled trial with 415
women. It should have been more clear that it was a randomized trial.
The story accurately represents the prevalence of ovarian cancer and the
survival.
Independent
source is quoted.
The author does mention intravenous chemotherapy as the alternative and explains
the advantages and disadvantages of the new approach.
Clearly this treatment is available in the U.S., but it’s not clear how widely available it is
and how many oncologists have experience using it.
The story does not mention
if the treatment is new or not.
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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