Cancer patients and their families have bought into treatments that don’t work, cost a fortune, or cause life-threatening adverse effects, according to a report from Kaiser Health News (KHN). While the media blare news that America is winning the cancer war; pharma companies promise “a chance to live longer” to boost sales; and hospitals woo customers with ads that appeal to their hopes and fears, the fact remains that most patients with advanced cancer will eventually die of their disease.
“We have a lot of patients who spend their families into bankruptcy getting a hyped therapy that [many] know is worthless,” said Dr. Otis Brawley, chief medical officer at the American Cancer Society. Some choose a drug that “has a lot of hype around it and unfortunately lose their chance for a cure.”
For decades, researchers have rolled out new cancer therapies with great fanfare, announcing that science has at last found a key to ending one of the world’s great scourges, said Dr. Vinay Prasad, an assistant professor of medicine at Oregon Health and Science University. When such efforts fail to live up to expectations, the cancer world simply moves on to the next big idea.
Hyping early scientific results—based on lab tests or animal studies—can attract investors, who allow researchers to continue their work, and positive results can lead small biotech firms to be bought out by larger drug companies.
Even the country’s top scientists sometimes get carried away, the KHN article notes.
In 1998, Nobel laureate James Watson—who codiscovered the structure of DNA—told The New York Times that scientists would “cure cancer in two years” using drugs that block tumor blood supplies. At that time, the drugs had succeeded only in mice.
In 2003, the director of the National Cancer Institute, Dr. Andrew von Eschenbach, announced a goal of “eliminating suffering and death due to cancer by 2015” through better understanding of tumor genetics.
It’s easy to see how patients’ hopes may be raised, considering the marketing blitz that accompanies every new cancer drug.
A TV commercial for the Bristol-Myers Squibb drug Opdivo projects the words “a chance to live longer” on the side of skyscrapers as a captivated crowd looks on. In much smaller type, a footnote reveals that lung cancer patients taking Opdivo lived only 3.2 months longer than others.
Another TV ad, for Merck’s Keytruda, features reassuring images of a smiling, healthy patient hugging her family—not fighting for breath or struggling to walk. Although the commercial notes that the people in the ad are portrayed by actors, the commercial says the drug provides “a chance for a longer life. It’s Tru.”
The Keytruda ad notes that 71% of patients given the drug were alive “at the time of patient follow-up,” compared with 58% of those who received chemotherapy. The ad doesn’t mention that the “time of follow-up” was 11 months.
Hospitals also have drawn criticism for overstating their successes in treating cancer. In 1996, Cancer Treatment Centers of America, a for-profit chain, settled allegations from the Federal Trade Commission that “they made false and unsubstantiated claims in advertising and promoting their cancer treatments.”
The company’s current commercials—dozens of which are featured on its website—boast of offering “genomic testing” and “precision cancer treatment.”
The commercials don’t tell patients that genetic tests—which aim to pair cancer patients with drugs that target the specific mutations in their tumors—are rarely successful, Prasad said. In clinical trials, these tests have matched only 6.4% of patients with an appropriate treatment, according to a 2016 article by Prasad published in Nature. Further, because these drugs shrink only a small fraction of tumors, Prasad estimates that just 1.5% of patients benefit from precision oncology.
The KHN article notes that researchers have tested immunotherapies against a variety of tumors, leading to approvals in lung cancer, kidney cancer, bladder cancer, and others. Such success, in turn, has led doctors to label cancer immunotherapy as a “game changer,” and newspapers and magazines to call it a “breakthrough.” And yet these treatments—which were initially assumed to be less harmful than chemotherapy—can provoke fatal immune-system attacks on the lungs, kidneys, heart, and other organs, according to the KHN article.
Only about 10% of all cancer patients can expect to benefit from immunotherapy, Prasad said.
Source: Kaiser Health News, April 27, 2017.