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Don't Let Cancer Immunotherapy Hope Give Way To Hype

This article is more than 7 years old.

By Alaric DeArment

From the Obama administration’s “Moonshot” initiative to Sean Parker’s $250 million funding pledge, cancer immunotherapy has become one of the hottest fields in medical research. In particular, it has generated tremendous excitement among physicians, patients, investors and journalists.

So how can news media and the general public prevent hope for cell therapies, cancer vaccines and checkpoint inhibitors from turning into hype?

To be sure, many of the new therapies have shown significant promise. As many as 80-90% or more of patients with acute lymphoblastic leukemia (ALL) taking CAR-T cell therapies have seen their tumors disappear and stay gone for long periods; it’s too early to call that a “cure,” but it’s far better than the dismal results they got before. Checkpoint inhibitors like Bristol-Myers Squibb ’s Opdivo and Merck ’s Keytruda have produced strong results in a variety of tumor types ranging from metastatic melanoma to Hodgkin’s lymphoma.

Cancer vaccines’ record has been spottier. Dendreon’s prostate cancer vaccine Provenge never quite caught on; a much-anticipated clinical trial of Celldex Therapeutics’ glioblastoma vaccine Rintega failed; and Northwest Biotherapeutics’ nearly decade-old glioblastoma vaccine trial has become such a never-ending story that the company might as well conduct it in Fantasia and appoint Falkor the dog-dragon as CEO.

Meanwhile, despite its promise in ALL, CAR-T has shown less robust benefits in non-Hodgkin’s lymphomas. Given that NHLs already have numerous therapy options, CAR-Ts -- with their complex administration and likely cost of hundreds of thousands of dollars per patient -- are less certain to shift the NHL treatment landscape so dramatically. The same could be true with multiple myeloma, in which they similarly have not shined as brightly as in ALL.

These are the kinds of distinctions that journalists and the public should bear in mind when evaluating new treatments for cancers.

Misplaced media hype around health care is nothing new, but cancers raise the stakes because of the dread surrounding them and their becoming a leading cause of death in the U.S., even as numerous advances in therapy have appeared, said New York University science journalism master’s program director Dan Fagin and author of the Pulitzer Prize-winning book “Toms River,” and Susan Dentzer, a healthcare journalist and policy adviser at the Robert Wood Johnson Foundation. While it’s hard to quantify the effects of skewed coverage on patients and their families, it can nevertheless hinder their ability to make the best decisions, said MedPage Today global editorial director Ivan Oransky.

In a letter in the October 2015 edition of JAMA Oncology, Oregon Health Sciences University hematologist-oncologist Vinay Prasad and coauthor Matthew Abola analyzed nearly 100 news stories appearing June 21-25 on Google News, looking for superlative terms like “breakthrough,” “miracle,” “revolutionary” and “cure.” In 55% of cases, it was journalists themselves using such language to describe drugs not approved by the Food and Drug Administration and, in some cases, not even tested in humans.

The letter doesn’t specify the outlets or articles used, and Prasad declined to provide them, which limits the ability to fully vet his and Abola’s methods. When University of Georgia journalism professor Patricia Thomas plugged the same search terms into Google, she said the results included public relations news services, minor publications and television stations, in contrast to the more responsible coverage from top-tier news organizations.

Nevertheless, such coverage is not difficult to find. “We see this in spades all the time,” said HealthNewsReview.org publisher Gary Schwitzer.

For example, in the VICE-produced documentary “Killing Cancer,” which aired on HBO in February 2015, VICE CEO Shane Smith gushed that immunotherapy researchers were “on the verge of curing cancer,” phrasing that drew criticism from several experts. VICE did not respond to requests for comment.

A cure, Prasad said in an interview, means that a patient can be expected to live as long as if she never had cancer. Remissions, he emphasized, are not cures. And even using “cancer” in the singular is problematic because it’s not just one disease, but several, Dentzer added. To wit, expecting a “cure for cancer” is like waiting for a magic pill to cure every possible virus.

An Aug. 19, 2015 Time article by reporter Alice Park carried the headline “How Doctors Cured This Woman’s Brain Cancer.” Neither Park nor Time responded to requests for comment, and it is unclear whether she wrote the headline, given that the article itself states the woman’s doctor did not say she was cured. But the brain cancer in question, glioblastoma, is both incurable and rapidly fatal.

While many treatments described in terms like “groundbreaking” really are, when therapies like CAR-T get a lot of press, many patients don’t realize the limitations such as how hard it is getting into clinical trials, the need to travel for them and so forth, said Cleveland Clinic hematologist-oncologist Anjali Advani.

Those limitations – such as clinical trial data that don’t give a complete picture of how well a drug works or drugs that work well but only in certain kinds of patients – deserve greater emphasis and more prominent placement in stories, Schwitzer and Oransky said. The same goes for doctors’ conflicts of interest, Prasad said, noting that doctors will often not speak negatively of a drug if they have financial relationships with the companies that make them.

Still, overheated and incomplete cancer reporting isn’t all journalists’ fault and often reflects heated rhetoric from politicians and others, Dentzer said. “[Let’s] make America the country that cures cancer once and for all,” President Barack Obama said in his 2016 State of the Union Address. Schwitzer pointed to newsroom cutbacks that have led to many untrained journalists covering healthcare as they would any beat like sports or crime, while Oransky and Fagin said universities and other institutional communicators should be held accountable.

But it’s up to us journalists to make sure we’re giving the public the most accurate and useful information without creating unrealistic expectations.

BioPharm InsightAlaric DeArment, based in New York, covers cancer drug development for BioPharm Insight, a product of Infinata, part of the Mergermarket Group, providing investigative journalism and analytics on life sciences. He can be reached at adearment@biopharminsight.com or follow Alaric on Twitter at AlaricD_BPI.