This story was reported entirely from a Merck news announcement that immunotherapy drug Keytruda (pembrolizumab) did better than chemotherapy at extending the lives of certain patients with esophageal cancer.
On the plus side, the story conveyed some information about the drug’s availability. However, it didn’t didn’t say how much the drug costs, how long it extended survival, or what the potential harms might be.
It also passed along without scrutiny Merck’s assertion that this is the first time a drug of this type has helped those patients live longer.
We can anticipate Reuters reading our review and responding that their audience is different – it’s a business audience. Well, whether you’re flying in business class or coach, you may run into this story in the same way – by searching for Keytruda online. And whether you’re an investor or a patient, some of your basic informational needs are the same. And you didn’t get those needs answered in this piece.
The new trial results on Keytruda for digestive tract cancers haven’t been presented at a scientific conference yet, much less been submitted for peer review.
Too much, too soon.
No matter whom you’re writing for, it’s the job of journalism to independently vet claims. And there was no evidence of that in this story.
That’s the biggest take-home of what matters in this story: an example of health care journalism abdicating its responsibility.
Costs were not mentioned and that’s a big omission when you’re discussing Keytruda. Drugs in this class of checkpoint inhibitors are estimated to cost about $150,000 a year.
Passing along the drug company’s announcement that a drug “met the main goal of a late-stage trial” doesn’t come anywhere close to explaining what was found in that trial.
The story said “Keytruda, when compared to chemotherapy, enabled certain patients with esophageal cancer to live longer.”
But what percentage of patients lived longer? And by how much? How did the drug affect their quality of life? Those questions weren’t addressed.
When you’re simply passing along information spoonfed to you by a drug company, you’re not likely to explain or quantify the potential harms. And, indeed, Reuters didn’t even nod in the direction of discussing harms.
Merck’s news release unhelpfully said the “safety profile of Keytruda in this trial was consistent with that observed in previously reported studies.”
In our 6 tips for writing about immunotherapy, we note that harms of immunotherapy drugs — which can include serious adverse effects such as diarrhea and pneumonitis — are often downplayed
The quality of the evidence is impossible to ascertain since the story is based on a Merck announcement – made before the trial results were even presented at a scientific conference, much less published.
The story didn’t engage in disease-mongering, but it also didn’t include information beyond what was in Merck’s news release. It only passed along the company’s information that esophageal cancer is the “seventh most commonly diagnosed cancer in the world.”
The story could have reported that according to government data, 17,290 new cases of esophageal cancer are expected in the U.S. this year, comprising 1% of all new cancers and 2.6% of cancer deaths. About a fifth of patients die within five years.
There were no independent sources quoted in the story – only Merck statements about Merck’s own drug.
The story simply stated that “Keytruda, when compared to chemotherapy, enabled certain patients to live longer.” No basis for that comparison was provided.
A review of this class of drugs pointed out that another PD-1 inhibitor, Bristol-Myers Squibb’s Opdivo (nivolumab), has also shown to improve survival (albeit marginally) in gastric cancers.
In addition, Endpoints News noted that another PD-1 drug is being tested by Celgene and BeiGene to treat esophageal and esophagogastric cancers.
We’ll give the story the benefit of the doubt on this one because it explained that the drug is Merck’s top selling drug and has already been FDA-approved for use in other cancers.
However, the story didn’t explain that because Keytruda is not approved for use in gastric cancers, some providers including Medicare supplement providers, may not provide coverage.
The story quotes a Merck executive saying this was “the first time an anti-PD-1 therapy has achieved overall survival for this patient population.”
However, as we noted earlier, published reports suggest otherwise.
Everything in the story appears to be based on a Merck announcement.
Systematic, Criteria-Driven
The tale of two “negative” studies. Or, how spin is applied to make research findings look more impressive. A must read. https://johnmandrola.substack.com/p/the-tale-of-two-negative-studies
The @nytimes chose to interview one of the editors of the @AnnalsofIM (publisher of this paper) who "gushed with extraordinary glee: It’s huge! There are very few things that reduce your mortality by 30%."
Turns out coffee is not one of those few things despite all that glee. https://twitter.com/garyschwitzer/status/1533202075928215558
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