January 3, 2017 Read Original Story

By including independent viewpoints, STAT takes a more measured approach to coverage of brain cancer immunotherapy

Reviewed By

Rating

CAR-T therapy makes early inroads in treating brain cancer

Our Review Summary

This story in STAT, like the one in TIME.com that we also reviewed, describes the successful, and apparently first positive response of a glioblastoma brain tumor to CAR-T therapy. This is an experimental immunotherapy that depends on on injections of modified immune cell proteins and that has had a few successes in blood cancers but essentially none in solid tumors, including those in the brain.

Described in a report in the The New England Journal of Medicine, the study was conducted and promoted by officials and physicians at the City of Hope Beckman Research Institute and Medical Center, an organization that has a somewhat unfortunate history of touting treatments as bringing about “miracles” and encouraging coverage of compelling individual cancer patient stories to support sometimes exaggerated claims of major advances in cancer treatment.

This STAT story does a better job than TIME of putting what is essentially a single, unexpected experimental result into perspective. Its strongest points are that it avoids touting this one patient’s experience as any kind of broad “success,” calling it an “early inroad;’ emphasizing its “notorious” potential side effects; and most of all quoting sources outside City of Hope who made clear that, as one put it, the success was possibly a “flash in the pan.” Bravo. One thing that would have made the story stronger? Early on emphasizing how a single case study makes for weak evidence. See our six tips for writing accurately about cancer immunotherapy drugs.

Why This Matters

Unlike the TIME story (see our review), this story included important voices of caution to help keep expectations in check. Starting with the headline, readers of this story are likely to come away with a more realistic perspective on this treatment. (Meanwhile, TIME’s headline was misleading: “Experimental Brain Cancer Treatment Is a Success.”)

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

As we noted in our review of TIME Magazine’s story as well: Although there may not yet be any accurate prediction of the cost of the particular therapy described for this single patient, it is generally well established and well documented that immunotherapies–particularly those that involve modifying a patient’s own immune cells–are many times more expensive than standard treatments, sometimes running to annualized costs in the hundreds of thousands of dollars. This story says nothing about this.

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

Not Satisfactory

The article notes that the patient was in remission for seven months, but like the TIME article, says nothing specifically about what the patients tumor status was during those seven months. If the tumors shrunk, it would be at least useful to know the baseline measurements and degree of shrinkage and disappearance, as well as any improvements or (setbacks) in quality of life.

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

Satisfactory

This was a tough call, but we’re leaning toward satisfactory.

On one hand, the STAT story does acknowledge the downsides, so far, of CAR-T therapy, by referring to the adverse events as “notorious” and providing a link for more information.

On the other hand, the story only mentions that severe side effects have occurred without telling us any of those side effects and what the side effects (if any) were for the one patient treated. Instead it says the patient’s side effects were “fairly innocuous” and quotes a researcher early in the story saying “it’s amazing how safe it was.” Yet, this hardly proves it’s safe.

See our tips for reporting accurately about the harms, side effects and risks of immunotherapy.

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

Satisfactory

The story does make it clear that this was an intervention tested in a single patient, and includes cautious statements from experts. This is a barely passing satisfactory–we think the story could have more emphatically said that any single case study cannot and should not be used to generalize the efficacy of any therapy until more reliable studies are done.

Does the story commit disease-mongering?

Satisfactory

No mongering here regarding the brain cancer glioblastoma.

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

Satisfactory

Job well done in quoting sources outside of the City of Hope investigators and putting the findings into cautious perspective throughout the article. If the story was to be done at all (a debatable decision), this article makes the best of the context problem.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

Very few details of conventional alternative treatments are included, but the story points out that glioblastoma is resistant to most treatment options. Still, the story should have noted that alternatives include surgery, radiation and chemotherapy.

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

Satisfactory

The STAT story notes the availability of CAR-T commercially (by naming the companies) for blood cancers, and it quotes an outside source as essentially saying “don’t hold your breath” awaiting the viability of this treatment for glioblastoma.

Does the story establish the true novelty of the approach?

Satisfactory

The article does a brief but adequate job of describing what is newsworthy here–how this experimental CAR-T is being used for solid tumors for the first time.

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

Satisfactory

The story possibly may have started with the news release, but it reflects useful additional outside reporting.

Total Score: 7 of 10 Satisfactory

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