As noted by both of the stories we reviewed, researchers have been trying to find a way to use genetically engineered cells to fight cancer for 20 years, making even a small study like this interesting news. Both stories sounded some cautionary notes, but WebMD did a better job overall of helping readers see that the study’s findings were promising but not proof that a cure for leukemia is around the corner. This makes the WebMD headline all the more unfortunate because the body of the story is full of much more specific and relevant information.
Unlike the Reuters story, this story did not discuss costs.
The story described very well the specific experiences of the patients who were involved in the study. It showed how two were in full remission and one was in partial remission.
But someone at WebMD has to take responsibility for that headline and the repeated reference to “cure” that is bothersome. Even when the story finally comes around to asking “Is he cured?” it still fails to directly address the unknowns and uncertainties. “Cure” is such a loaded term – it is almost unhelpful in discussing such research.
Even if investigators choose to use that term, journalists have an obligation to tackle the age-old baggage and consumer confusion that comes with it. This story started to try to do this, but fell short in our eyes.
In a three-person study, it’s difficult to quantify harms or benefits beyond just describing what happened to each patient. The WebMD story, though, did a better job of presenting the very real side effects of the study, even showing that the treatments for the side effects may have hampered the effectiveness of the cancer therapy. “The treatment was not a walk in the park for patients. One of the three patients became so ill from the treatment that steroids were needed to relieve his symptoms. The steroid rescue may be why this patient had only a partial remission.”
This story was superior to the Reuters story in evaluating the quality of the evidence. For example, it said right in lead that the study was only on three patients. It also provided more qualifiers for the findings than the Reuters story. It said, for example, “Although the CAR T cells in the study were designed to fight CLL, there’s good reason to hope they can be effective in other forms of cancer. The catch is that it can work only on tumor cells that carry markers flagging them for destruction. Normal cells that carry the same markers will also be destroyed.”
Both stories could have used more outside sources. In each case, only one outside source was quoted. In the WebMD case, the outside source was overly effusive. In the Reuters case, the outside source did a better job tempering some of the enthusiasm of the authors with a realistic assessment of the treatment’s prospects.
The story talked about bone marrow transplants, while the Reuters story made no mention of them. This was an important comparison for readers. “Cure is possible, but it requires a risky bone marrow transplant. About 20% of patients don’t survive this treatment — and even when they do, there’s only a 50-50 chance of a cure.”
This story did a great job placing the findings into context and showing exactly why they have been found so promising by the study’s authors and other researchers. “All this has been done before. These genetically engineered cells are called chimeric antigen receptor (CAR) T cells. They kill cancer in the test tube. But in humans, they die away before they do much damage to tumors. What’s new about the current treatment is the addition of a special signaling molecule called 4-1BB. This signal does several things: it gives CAR T cells more potent anti-tumor activity, and it somehow allows the cells to persist and multiply in patients’ bodies. Moreover, the signal does not call down the deadly all-out immune attack — the feared “cytokine storm” — that can do more harm than good.”
The story went well beyond any news release, but one could argue that the extensive use of patient quotes taken from a university news release is not the best journalistic practice.