Factual · Powerful · Original · Iconoclastic
In the wake of three studies published in the prestigious New England Journal of Medicine, news outlets around the world pronounced the highly-expensive drug Herceptin to be literally a "cure" for breast cancer. As I pointed out in my column last week, for about three-fourths of women it's utterly useless. It only helps if the tumor emits a certain protein that most do not. Yet even for such women, on whom the studies were conducted, the studies were far too short and the data far too unconvincing to possibly justify such hype. Now Britain's Number One medical journal, The Lancet, and America's Number Two medical journal, the Journal of the American Medical Association (JAMA), have weighed in. Conclusion. We're looking at Herceptin Horse Hockey.
"The available evidence is insufficient to make reliable judgments," The Lancet stated in an online editorial. "It is profoundly misleading to suggest, even rhetorically, that the published data may be indicative of a cure for breast cancer." The editor told reporters, "Study results are preliminary, inconsistent and raise extremely serious concerns about safety."
JAMA, meanwhile, ran a letter critiquing the policy of cutting drug trials short simply because it looked like the group receiving the medicine was doing better than that which wasn't. The Herceptin trials (which were originally announced last May) were examples. The idea of "breaking the code" and giving everybody the drug is that it's the ethical thing to do; but in reality you lose a tremendous opportunity to distinguish the value -- and potential harm -- of a drug over a longer period of time. In some cases a drug that in the short run appears effective in a slightly long trial loses its effectiveness.
Now I'm getting letters from women with breast cancer (or who have friends with it) blasting me for NOT lying to them. Go figure; they can't tell the difference between a responsible science writer and a politician.