While the story does many things well, the overall framing of the story is that the vaccine “shows promise,” when the evidence actually points in the other direction. Because only one patient in the study remains cancer free and because that patient may very well have benefited from an earlier cancer vaccine and other complicating factors, we question the decision to write this story in the first place.
Right now, there more than 10,000 cancer-related clinical trials recruiting patients. Cancer has foiled scientists repeatedly with treatments that initially seemed promising in the laboratory or in a very small group of people and later proved unworkable on a larger scale. It’s a difficult task — but a crucial one — for reporters to ask tough questions of the evidence and a wide range of sources before deciding whether one of these thousands of experimental treatment options merits coverage.
The story does discuss costs, but the framing is problematic. The story, based on a conversation with one source, the study’s lead investigator, says, “It’s difficult at this point to predict costs. However, he expects costs will not approach those for Provenge, the pricey treatment vaccine for prostate cancer approved by the FDA in 2010. Provenge costs $93,000 for the one-month, three-dose treatment. Medicare covers it.” This tells readers that, no matter what the drug costs, Medicare likely will cover it. We appreciate the effort to bring cost information into the story, but this type of information is misleading.
The story does explain that only one patient remains cancer free following the study. It then details how for most of the patients cancer continued to progress after 2 months. It says that the median overall survival in both the breast cancer and ovarian cancer patients was less than 16 months. But the story is framed in such a way to highlight the one potentially positive outcome of the study and to downplay the negative. We read more sooner about the one patient who may have responded well to the vaccine than we do about the 25 other patients who did not.
The story mentions side effects in a satisfactory way.
Technically, the story provides readers with much of the information they would need to assess the validity of the study, but it comes out in bits and pieces. For example, we only find out near the end of the story that “The woman, who remains disease-free, had a previous treatment with a different treatment vaccine. ‘That might have primed her immune system,’ Gulley speculates. She also had only one regimen of chemotherapy, perhaps keeping her immune system stronger.” This casts much doubt on the study’s design, and it would have been nice to have seen some outside expertise brought in to either discuss those design problems or to torpedo the story altogether.
Again, the story deserves high marks for being very specific in the lead and throughout the story. It says, that the vaccine is “for breast and ovarian cancer that has spread to other parts of the body” in the lead and later details the particular circumstances of the study cohort. It says, “The patients had already undergone a variety of treatments but the cancer was progressing. Twenty one of the 26 had undergone three or more chemotherapy regimens.”
This is the root of the story’s main shortcoming. Almost all of the information in the story comes from one source: Dr. James Gulley, who oversaw the study. Gulley is quite enthusiastic about this vaccine, despite the evidence, and the story needed more perspectives to put this vaccine into a broader context. At the very end, there are a few comments from Dr. Vincent K. Tuohy, who also is working on a breast cancer vaccine. Because of his competing research, he seems to have a conflict, but even putting that aside, his comments were not used to their best effect.
There was no comparison in the story to existing alternatives. The median survival, for example, is presented without the context of how long these patients might have lived had they been undergoing standard chemotherapy and radiation treatments.
We give high marks to the story for saying right in the lead that the findings are from “a preliminary study in 26 patients.” That tells readers both that the findings need to be interpreted with caution and that the treatment is not available to most people.
The concept of vaccines for breast/ovarian cancer is indeed novel, and the story acknowledges that other vaccines are being studied.
The story does not rely on a news release.