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A study that may help reduce overtreatment of breast cancer gets solid write-up by Bloomberg


4 Star


Study Finds More Isn't Better for Roche Breast Cancer Drug

Our Review Summary

rapid MRI for dense breastsThis Bloomberg story reports study findings that show the targeted breast cancer drug Herceptin may be as effective with a six-month treatment period as it is with the currently recommended 12-month treatment period.

The results, slated to be presented at the American Society of Clinical Oncology, could mean fewer adverse events and significant cost savings for patients. The story also makes clear that this finding is not robust enough to change treatment guidelines yet and that other outcomes, such as quality of life improvement are still being analyzed.


Why This Matters

Herceptin has been a hugely successful drug, both for patients with a particular type of breast cancer (tumors with HER-2 receptors, which occur in about 20% of all breast cancers) and for the drug’s maker, Roche. Approved 20 years ago, doctors are still learning how best to manage the benefits and harms of the treatment. This study looks at one way of refining treatment — by shortening the duration, saving on costs, and reducing cardiac toxicity events.


Does the story adequately discuss the costs of the intervention?


The story mentions that currently Herceptin costs $76,700 for 12-month treatment. Presumably that cost would be reduced with 6-month treatment, though it’s unclear to what extent. Readers also are told that the cost is expected to go down as similar drugs by other pharmaceutical companies enter the US market.

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


The story describes the main outcome of the study with numbers: “In both the six- and 12-month groups, about 90 percent of women were cancer-free after four years.”

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


The story makes clear that one motivation for reducing the overall course of Herceptin treatment was to reduce serious side effects, namely cardiac toxicity. Indeed, the shorter treatment halved the number of women who had to stop treatment because of heart issues, to about 4%.

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

The story noted the study size (4,000-plus women), the equivalency of the main outcome, and the reduction of harm. It made clear that analysis is ongoing on other important outcomes, such as quality of life. It also included mostly cautious positive reactions by the sources quoted, including the Chief Medical Officer of Roche, the drug’s maker: “Many, many people in the field have been looking at the question over a number of years, and these data will need to be viewed in the context of that larger group.”

However, there was no warning about the fact that the data is preliminary and no one can review it yet (no actual research was “released,” even though the story frames it that way). Important details and concerns may not surface until the complete data are available to be reviewed by the scientific community.

Does the story commit disease-mongering?


No disease-mongering here.

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

Not Satisfactory

The story quotes three sources: a study author, a representative from drug’s maker Roche, and an oncologist not involved in the study.

We would have liked to see a bit more information on these people. For instance, the Associated Press reported that the study author, Helena Earl “has consulted for Herceptin’s maker, Roche,” but the company had “no role in the study.”

Does the story compare the new approach with existing alternatives?


The story informs readers of other studies that have evaluated longer and shorter treatment durations, from six months (inconclusive results) to two years (no benefit).

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


The story makes clear that the current standard of care is 12 months of Herceptin treatment. It also cautions, near the top of the piece, that: “more research will be needed before a wholesale change in medical practice.”

Does the story establish the true novelty of the approach?


The story notes that this is the largest study to date that evaluates a short treatment duration for Herceptin and that it was funded by the UK’s National Institute for Health Research, not the drug company.

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


The story does not appear to rely on a news release.

Total Score: 8 of 10 Satisfactory


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