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Except for presidential anecdote, NBC story on new melanoma drug was well-balanced

Cancer Drug Keytruda Keeps Some Patients Alive For 3 Years

Our Review Summary

dermatoscope for skin cancer keytrudaFormer president Jimmy Carter announced in August 2015 that he had melanoma skin cancer that spread to his liver and brain. Months later, he shocked the world again by releasing a statement teasing he was in remission. He said a bit more before a videotaped Sunday school class he led, noting an immunotherapy drug called pembrolizumab — known better as Keytruda — was part of his treatment alongside surgery and radiation. (See our previous coverage: What the media got wrong about Jimmy Carter’s cancer cure.)

NBC News has followed the story since it broke last summer, and the outlet revisited it again on the coattails of a new study on Keytruda, published April 19, 2016 in JAMA. NBC News’ latest story was also accompanied by a 2-minute video.

The stories together do a nice job of walking readers through the study’s numbers, how pembrolizumab might work, the side effects, costs, and other details. It also cites several researchers who weren’t involved with the study and addresses a key issue with hype by stating the study’s finding “doesn’t mean a cure.”

This vivid picture of success may set readers up for false expectations of benefit. Because as the story itself points out, a majority of patients treated with the drug didn’t live longer than three years.

 

Why This Matters

Melanoma is an increasingly common form of cancer, likely due to the rise of tanning’s popularity and other risk factors. But it’s also the most lethal form of skin cancer, according to the American Cancer Society, killing more than 10,000 of 76,000 people diagnosed each year in the United States. A new drug that improves life span is certainly a welcome idea.

 

Criteria

Does the story adequately discuss the costs of the intervention?

Satisfactory

The video claims the cost is about $150,000 a year and is “covered by insurance.” The text story notes how pricey it is and states “Keytruda costs about $12,500 a month, or $150,000 a year.”

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

Satisfactory

We’re given the total study population of 655 people with advanced melanoma, and how the average patient lived 2 years. The story also notes a 3-year survival of 40%, which the headline teases, and notes a 15% “complete remission” result. We’re also glad the story was frank about the fact that 60% of patients didn’t live three years.

The story does a nice job putting those numbers into perspective by quoting Tim Turnham, executive director of the Melanoma Research Foundation, who notes people with a similar diagnosis typically only live 11 months.

Although no study can account for all variables, a doubling of lifespan with limited side effects is worth writing home about.

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

Satisfactory

Side effects are described — fatigue, itchiness, and rashes — and even notes the dropout rate of 8%.

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

Not Satisfactory

While we’re given some study details, we’re not told where the study was published, nor what type of study it was. In fact, it was published in the Journal of the American Medical Association, and it was what’s considered a Phase 1 trial to determine safety of the drug.

An accompanying editorial in JAMA provides a bit of context to the study result and is perhaps best summed up with the title: “PD-1 Blockade in Melanoma, A Promising Start but a Long Way To Go.”

Or as it was mentioned in the news release: …”it is difficult to make any definitive conclusions based on this single-arm, early phase trial.” This means that in addition to this being a trial to determine safety, the research was limited in many important ways that weren’t addressed in the story.

We also want to note that the story made mention of this getting “breakthrough” approval by the FDA--which needs more context given the misleading sound of that word.

Does the story commit disease-mongering?

Satisfactory

We didn’t see any gratuitous or frightening description of melanoma’s many symptoms or treatment side effects.

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

Satisfactory

At least two outside sources were quoted in addition to a study spokesperson.

Does the story compare the new approach with existing alternatives?

Satisfactory

The story says the majority of participants in the study had Stage IV disease and had limited treatment options. It also briefly discusses the other alternative treatment, i.e. ipilimumab.

While this is Satisfactory for this criterion, we would have liked to see more general information about how melanoma is treated, including surgery, chemotherapy, and radiation therapy.

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

Satisfactory

The story makes it clear that Keytruda was approved by the FDA in 2014 and is commercially available.

Does the story establish the true novelty of the approach?

Satisfactory

This is made clear by a succinct walkthrough of how pembrolizumab might work, and a source’s statement about average life expectancy.

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

Satisfactory

Though NBC News’ story quotes a press release from the American Society of Clinical Oncology, it’s not gratuitous and the vast majority of the article is comprised mostly of original reporting.

Total Score: 9 of 10 Satisfactory

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