CNN afforded an unusual amount of time to this story about a National Cancer Institute study, published in the journal Science, about a gene therapy approach for advanced melanoma. But there were some critical pieces of information missing from the story, even with the amount of time afforded it. While this experimental approach is, of course, of interest, it is important to be mindful that the majority of individuals diagnosed with melanoma are successfully treated using conventional methods. The gene therapy approach was not effective for most patients studied. When the story projected possible effectiveness of this mode of treatment to other forms of cancer, it left the world of evidence and entered the sphere of pure speculation.
The story didn’t discuss any side effects from the treatment and gave only cursory mention that the treatment was ineffective for the majority of patients involved in the trial (15 of 17 died). The story should have mentioned that because so few people have experienced this gene therapy approach, there is insufficient information about the potential harms.
The only source of information used on the air was the principal investigator of the study. Inclusion of other clinicians involved with immunotherapy could have provided grounded estimates of the benefit and risks to patients. Other news media across the country offered such perspective on this story, offering a much more complete and balanced view. The story seemed particularly fawning, when the anchorman asked the principal investigator, “Do you need more money, more support, more help? Or do you have everything you need right now to see how far you can take this?” Other perspectives were needed to balance the story.
There was also no estimate given for the cost of such a gene therapy approach, not even a projection of what it might cost. There was also no mention that it was tested in patients who had received other treatments both before and after the immunotherapy. This is an important issue. If these experiments lead to a new therapy, it would make all existing forms of treatment look inexpensive. This would be individualized treatment in its ultimate form.
There was no estimate for the cost of such a gene therapy approach, not even a projection of what it might cost. There was also no mention that it was tested in patients who had received other treatments both before and after the immunotherapy. This is an important issue. If these experiments lead to a new therapy, it would make all existing forms of treatment look inexpensive. This would be individualized treatment in its ultimate form.
While featuring one patient who had a successful outcome (i.e. ‘virtually cancer-free’ 2 years after treatment), the story did mention that there were two patients in whom the experimental approach was successful and 15 people for whom it was not effective. However the air time given to the success was far greater than that given to the point that this experiment did not benefit ~88% of the patients, a point that is important for viewers to understand.
There was no mention of side effects from the experimental approach and only cursory mention that it was ineffective for the majority of people involved in the trial (15 of 17 died). The story should have mentioned that because so few people have experienced this gene therapy approach, there is insufficient information about the potential harms.
The story explained that the results presented were drawn from a clinical trial, with results being published in the journal Science.
This story failed to inform the viewer about how common death from melanoma is. While it presented an estimate for the number of Americans that will be diagnosed with melanoma in 2006 (~ 60,000) there was no mention that it is estimated that there would be <8,000 deaths attributable to melanoma. This information is helpful for recognizing that melanoma is much less common and deadly than a number of other diseases.
The only source of information used on the air was the principal investigator of the study. Inclusion of others clinicians involved with immunotherapy could have provided grounded estimates of the benefit and risks to patients. Other news media across the country offered such perspective on this story, offering a much more complete and balanced view.
There was no mention of the use of autologous tumor infiltrating lymphocyte treatment which, although effective in roughly half the patients for whom it is an option, is not a possibility for all patients. The was no meaningful discussion of surgery, chemotherapy, radiation therapy, and biologic therapy that are currently used in the treatment of melanoma. The story didn’t explain that at least some of these treatments were used in conjunction with the experimental treatment.
This report mentioned several times that this is a highly experimental approach and that it was still currently only in the clinical trial stage. No estimate was provided for when this type of experimental approach might be more readily available, but this research is at such an early phase that it is difficult to predict.
The impression from this piece is that the study reported on was the only one of its kind. The approach of using cells from a patient’s own immune system as part of the therapeutic approach to the treatment of cancer is an area of active investigation. The current study is one of several clinical trials underway to determine whether this approach will be effective for the treatment of melanoma. This is, however, the first time that anyone has actually seen a positive, durable response.
The story does not appear to rely solely on a news release.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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