Drug Extends Prostate Cancer Survival

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

No mention of costs.  The competing Wall Street Journal story, by comparison, reported: "Cost could be a factor. The three-treatment Provenge regimen has been controversial partly because of the $93,000 cost. Dendreon has said treatment costs are comparable with chemotherapy if total costs of care are taken into account."

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

WebMD reports the data incorrectly–it’s median survival, not average survival. This implies that 50% of the patients had more than a 4-month survival, but the story (assuming that investigators provided data, which they might not have) should then provide the upper range of survival times (e.g., 11 months) to quantify "better."  They could also report that X% survived for 6 months, Y% for 12 months, etc. (though the latter may be 0). 

This story seemed determined to put this study in the best possible light, reporting that "The treatment gave patients with metastatic, castration-resistant prostate cancer only an extra four months of life. But there’s more hope than that from the study…"  What does that mean? 

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

There was no discussion of harms of hormone therapy – harms that may include osteoporosis, fractures, diabetes and heart disease.  This is a significant oversight.

Does the story use independent sources and identify conflicts of interest?

Not Satisfactory

There is no independent voice or perspective in the piece.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

There was no meaningful comparison with other approaches.

One last time, let’s look at how the competing Wall Street Journal story tried to give such context: 

"When you have drugs that act in different ways and each is giving some measurable benefit, that is significant progress in a field where new agents have come along very rarely in the past," says Steve K. Clinton, director of prostate and genitourinary oncology at Ohio State University’s James Cancer Hospital and Research Institute, Columbus. Dr. Clinton wasn’t involved in the current study and doesn’t have consulting relationships with the companies.
 

• "The abiraterone study, presented at the European Society for Medical Oncology meeting in Milan, follows approval earlier this year of two other therapies—Jevtana, a chemotherapy agent from Sanofi-Aventis SA, and Provenge, a cancer vaccine developed by Dendreon Inc., which marshals the immune system to fight the disease. Still, the overall improvement is modest for each therapy. Jevtana increased survival by an average of 2.4 months compared with standard chemotherapy. Provenge added an average of 4.1 months of life. Researchers say the results are impressive nevertheless because the studies involved patients whose tumors progressed after treatment with several different therapies. Assuming abiraterone wins regulatory approval, oncologists will have to work out how it fits with the other new remedies. "What we really need that we don’t have at the moment is the wisdom to know which one to use at what time and in what order," Dr. Clinton says. Cost could be a factor. The three-treatment Provenge regimen has been controversial partly because of the $93,000 cost. Dendreon has said treatment costs are comparable with chemotherapy if total costs of care are taken into account. Chadi Nabhan, division director of hemotology/oncology at Advocate Lutheran General Hospital, Park Ridge, Ill., and an investigator on Provenge studies, says he doesn’t see the treatments as rivals. It is possible that by giving one treatment after the other, doctors will be able to extend life beyond what’s possible with one strategy alone, he said." 

That’s an example of the kind of context – the kind of comparison – we look for in such stories.

Does the story establish the availability of the treatment/test/product/procedure?

Not Satisfactory

The reader is given no information about whether this drug is available now, or, if not, what stage of research it is in.  There’s a hint – in the line that Johnson & Johnson is "developing" the drug but news organizations shouldn’t play guessing games with readers on the topic of the availability of prostate cancer drugs – or any topic.

The competing Wall Street Journal story, by contrast, reported: "Johnson & Johnson plans to file for new-drug approval in the U.S. and Europe by year-end, raising prospects that the drug could be on the market next year."  There’s no doubt about availability when you read that. (Although one could doubt the prediction of when it could be on the market.) 

Does the story establish the true novelty of the approach?

Not Satisfactory

The story didn’t provide any meaningful context about possible novelty of this approach.  Again, let’s turn to the competing Wall Street Journal story for comparison.  It reported: "Androgen hormones, particularly testosterone, fuel prostate tumors. Conventional hormone therapy blocks androgens produced by the testes. Abiraterone appears to target androgens also produced elsewhere, even by the tumors themselves, said Dr. de Bono, who presented the study in Milan."  This story only told us that "It appears that abiraterone is able to shut down androgen production not only in the testes, but also from the adrenal gland and from within prostate tumors themselves."  But that statement stands in isolation without any comparison to existing hormonal approaches.

Does the story appear to rely solely or largely on a news release?

Not Satisfactory

Given that the one quote in the story is attributed to a news release (at least they admitted that), and that there is no independent perspective in the piece, it appears that the story did rely solely or largely on a news release.