June 28, 2018 Read Original Story

Atypical patient anecdote throws off well-reported NBC News story on experimental brain cancer treatment

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Rating

Modified polio vaccine helps fight deadly brain tumors

Our Review Summary

brain cancer immunotherapy This is one of two stories we reviewed that cover results of a phase 1 trial to study the use of a modified poliovirus to fight glioblastoma, a fatal brain cancer. The results of the study were published in the New England Journal of Medicine. The story delves into the harms of the treatment and refrains from disease-mongering.

Yet the definitive cause-and-effect framing of the lead and the headline, along with a single non-representative patient anecdote, might lead readers to believe the evidence is stronger than it is. The story also lacked independent sources and a mention of other similar research. We also reviewed a story by NPR, which had similar shortcomings.

Why This Matters

Stories about experimental treatments for fatal conditions such as glioblastoma should shy away from cause-and-effect framing and overly positive anecdotes in order to avoid raising false hopes.

You can hear a podcast that describes the emotional pain that premature hype around a glioblastoma treatment inflicted on one patient and his family.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Applicable

There’s no mention of how much this might cost, but we’ll rate this N/A since the story makes it clear that this concept still requires more research.

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

Satisfactory

The story did give numbers, reporting that “21% or so of patients helped by the vaccine all survived at least three years,” while 4% of patients in the the historic control group were alive after three years. But in a small study, why not give readers the absolute numbers: how many out of how many? Why make them do the math in their heads?

Some of data were incomplete. For example, the story said of the 61 treated, “eight patients had no evidence of the tumors growing any more and two had no evidence of a brain tumor at all,” without indicating how much time had passed since those patients were diagnosed and treated.

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

Satisfactory

Better than the NPR story that we also reviewed, NBC did a good job of spelling out harms, stating 19% of patients had “notable adverse events” and more than a quarter experienced brain damage affecting speech and communication. Again, though, we think it’s better to give readers the absolute number of adverse events – how many out of how many?

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

Not Satisfactory

The story did some things right on this score, but we wish it had refrained from cause-and-effect language and the inclusion of a single — extremely positive — patient anecdote.

To its credit, the story stated in the second graph that this is “no miracle cure.”

However, we take issue issue with the lead’s definitive tone, which stated that the treatment “helped some patients live for years longer.” That assertion was echoed in the headline. The journal manuscript did not use such language, but referred only to the survival rate being higher than the rate among historical controls.” As the American Cancer Society states, “(Phase I) studies are not designed to find out if the new treatment works against cancer.” Their primary focus is on whether the approach is safe. So the “helped some live for years longer” language is misleading. More trials with randomized controls are needed to determine whether this treatment actually led to better outcomes.

The story quoted a 20-year-old patient who said she was “amazed” at her improvement after taking the treatment. However, the story didn’t alert readers that she was one of just two of the 61 to have survived six or more years.

Lastly, the story should have described limitations of using a sample of past patients as a control group — a practice that might generate more favorable findings than a randomized control trial.

Does the story commit disease-mongering?

Satisfactory

The story didn’t exaggerate the prevalence of this disease.

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

Not Satisfactory

The story has no independent sources, and does not mention that seven study authors have a financial tie with a firm that holds the patent.

Does the story compare the new approach with existing alternatives?

Satisfactory

The story mentioned standard treatment for glioblastoma can include surgery, chemotherapy, and radiation.

However, the story would have been stronger if had mentioned that there are other experimental viral treatments under study for glioblastoma.

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

Satisfactory

The story makes it clear that this is an experimental treatment and is not widely available.

Does the story establish the true novelty of the approach?

Not Satisfactory

The story made it sound like this was a new concept, but this research has been dancing in and out of the sensational spotlight for years.

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

Satisfactory

This story does not rely on a Duke news release although it does mimic the news release’s cause-and-effect framing.

Total Score: 6 of 9 Satisfactory

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