An analysis of media coverage published in JAMA Oncology finds that the use of superlative terms to describe new cancer drugs is commonplace even when the drugs show only modest benefits or there is still a lack of clinical data to support enthusiastic statements.
The study, co-authored by a physician with the Knight Cancer Institute at Oregon Health & Science University, investigated 10 superlative terms in conjunction with “cancer drug” in Google News search from June 21 to June 25, 2015. Superlative terms included: “breakthrough,” “game changer,” “miracle,” “cure,” and “home run,” among others.
Using a set of pre-determined searches, researchers found 97 superlative mentions in the lay press that fit their criteria from 94 news articles and 66 distinct news outlets. Drugs described were in some stage of the research pipeline. Half of drugs described had not received FDA approval for any indication, and 14 percent of drugs were praised without any human data.
“While some cancer drugs in development are good and important, the majority are not game changers, and that means we as researchers have to do a better job at communicating the right amount of promise a therapy has,” says senior author Vinay Prasad, M.D., M.P.H., a specialist in blood cancers for the OHSU Knight Cancer Institute, and an assistant professor of medicine (hematology and medical oncology) in the OHSU School of Medicine. “If we pat ourselves on the back for every marginal accomplishment and call it a home run, it doesn’t force us to aim higher.”
Prasad and co-author Matthew Abola, a first-year medical student at Case Western University School of Medicine, found the use of superlatives reflects the current “hot fields” of cancer research, including immunology checkpoint inhibitors or targeted therapies. For example, immunologic checkpoint inhibitors comprised only 14 percent of the unique drugs mentioned, but accounted for 38 percent of all superlatives used. Targeted therapies were the most common drugs mentioned and received the most superlative use overall.
Overuse of superlatives also damages public understanding, Prasad continues. It creates a distorted picture of the way science works and unrealistic expectations for what science can accomplish in a single study. “Many of these superlatives should be reserved for treatments that change the way people with the disease conceptualize their lives because they work so well.”
Prasad adds, “We found that superlatives were used to describe drugs that have never been tested in people, based on only animal or laboratory data. Such language is always inappropriate and concerning given that so many drugs fail in the transition from the laboratory to human beings.”
Prasad notes that some use of superlatives is appropriate. Oncologists and patients are justifiably excited about several new targeted drugs, and checkpoint inhibitors. However, many other drugs described have not proved their worth. “Our goal as cancer researchers is not just to extend survival for six weeks,” he says. “Superlatives are warranted when a new treatment really changes the way people with the disease can think about their future.”
The majority of speakers using superlatives were journalists, at 55 percent, followed by physicians at 27 percent.
“Journalists may not have the expertise needed to back up those superlative phrases,” Prasad said. “Because patients and their families turn to media for research and information, we need to raise awareness on this issue.”
This work was not grant-funded. Abola is a medical student at Case Western University School of Medicine. Prasad was a National Institutes of Health employee when the study began; it was completed after he joined the OHSU Knight Cancer Institute.
About the Knight Cancer Institute
The Knight Cancer Institute at Oregon Health & Science University is a pioneer in the field of personalized cancer medicine. The institute's director, Brian Druker, M.D., helped prove it was possible to shut down cells that enable cancer to grow without harming healthy cells. This breakthrough has made once-fatal forms of the disease manageable. The OHSU Knight Cancer Institute is the only National Cancer Institute-designated Cancer Center between Sacramento and Seattle – an honor earned only by the nation's top cancer centers. It offers the latest treatments and technologies as well as hundreds of research studies and clinical trials.
Oregon Health & Science University is a nationally prominent research university and Oregon’s only public academic health center. It serves patients throughout the region with a Level 1 trauma center and nationally recognized Doernbecher Children’s Hospital. OHSU operates dental, medical, nursing and pharmacy schools that rank high both in research funding and in meeting the university’s social mission. OHSU’s Knight Cancer Institute helped pioneer personalized medicine through a discovery that identified how to shut down cells that enable cancer to grow without harming healthy ones. OHSU Brain Institute scientists are nationally recognized for discoveries that have led to a better understanding of Alzheimer’s disease and new treatments for Parkinson’s disease, multiple sclerosis and stroke. OHSU’s Casey Eye Institute is a global leader in ophthalmic imaging, and in clinical trials related to eye disease.