This TIME.com story describes a single-patient clinical test of injections of modified immune cell proteins, a type of immunotherapy known as CAR-T cell therapy. It 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 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 touted treatment as “miracles” and encouraged coverage of compelling individual cancer patient stories to support sometimes exaggerated claims of major advances in cancer treatment.
Unfortunately, this story carries a questionable headline (“Experimental Brain Cancer Treatment Is a Success”) and lacks any outside voices of moderation or caution about extrapolating lessons from a case study. In other words, this article could have done a much better job of contextual reporting. See our six tips for writing accurately about cancer immunotherapy drugs.
At least one other news story covering this same patient, appearing in STAT (see our review), did a better job of providing context and caution. Still, the value of reporting on these single cases remains in doubt.
Journalists and journals alike are clearly struggling with how and when (and perhaps most significantly, even whether) to report such individual cases, and more widely the painfully incremental advances in immunotherapies given their extremely limited (so far) success in bringing more than some months of life to 5 to 15 percent of patients at enormous financial, emotional and sometimes physical expense.
Perhaps the best (and most) that could and should have been reported here is that in an apparent “first,” this patient experiment demonstrated a temporary beneficial response to the therapy, and without serious side effects. The missing context from TIME’s story is that while its success in extending some possibly cancer-free time for one man is heartening for that patient, the study says very little scientifically because factors that accounted for the limited success and ultimate failure remain essentially unknown.
Do CAR-T cell therapies and other immunotherapies collectively hold the potential to work as a truly curative strategy for cancer? Many oncologists believe they do, but as we’ve seen in the past with anti-angiogenesis, interleukin, radiation, standard and combination chemotherapy, and surgery, successes are hard won, too often short-lived, and raise as many questions as they answer with respect to the individual genetic and epigenetic roots of cancer and its deadly spread.
In sum, stories like this need an FTC or FDA cautionary label: ‘This is a Single-Patient-Only Story. Read With Abundant Caution.’”
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.
The story fairly describes the patient’s course before and after the experimental treatment, and cites some data about the short life expectancy of patients with his type of brain cancer (glioblastoma). It could have done a much better job, however, of quantifying what actually occurred or is happening now in the other eight people undergoing the same therapy at City of Hope, and of defining specifically what it means to say the patient in the story had his tumor “under control” for “almost” eight months.
The article duly notes that CAR-T cell therapy has potentially dangerous side effects when used the way it was in in this trial, and acknowledges surprise on the part of the investigators as to why the patient did not develop them. The story might have been stronger if it had noted that the treatment is well known for serious side effects in experiments on patients with other forms of cancer. (See our tips for reporting accurately about the harms, side effects and risks of immunotherapy.)
Other stories about this patient, including the one in STAT that we also reviewed, extensively quoted those not involved in the study about the almost-anecdotal dimensions and strength of this trial. This story used a few phrases to tamp down expectations, but sorely needed other expert comment.
The story did not disease-monger about glioblastoma, a very deadly form of brain cancer.
No outside sources were quoted, which is a vital aspect of any journalism regarding City of Hope Medical Center, which we’ve called out for its “miracle mongering.” An independent source–such as we saw in our STAT review–can be a vital way to ascertain differing viewpoints on and help keep expectations in check.
The article does a pretty good job of describing the standard therapies available and, in this case, delivered to the patient.
The article makes clear that the therapy is experimental, that complexities are numerous, that much is still unknown, and the trial is ongoing.
The article ably describes what is novel about the way this immune therapy is created, and why it offers some hope as a strategy against a deadly cancer.
The story does not provide much beyond the news release, but did not appear to rely on it, as the story’s tone is not nearly as miracle-mongering as the news release.