We have two very different stories about the progress of cancer therapy this morning. We’ll start with the good part: the American Cancer Society says that death rates from the disease in the US dropped in the 2016-2017 period by their largest recorded percentage. This is unequivocally good news, and is attributed to advances in treatment – specifically, the advent of immunotherapies and of various targeted agents for lung and skin cancer. It may come as a surprise to some, but these death rates have actually been falling since the early 1990s at about 1.5% a year, a good part of which can be attributed to the decline in smoking. But the 2016-2017 decline bumped up to 2.2%, which has never been seen before. (There are some interesting conclusions to be drawn from the incidence and mortality figures considered separately; that’ll be the subject of a whole separate post).
When I talk to folks outside the research field, for several years now I’ve been saying that the oncology treatment landscape really has been changing. That has been clear to those of us on the inside, and here are the numbers to prove it. People are walking around today – going to work, watching their children grow up, making reservations for dinner with their spouses and friends – who would have been dead ten years ago with the same diagnoses. I believe that the data will continue to show this effect going forward, because we’re still making progress. It’s an interesting question whether the 2.2% decline represents a “bow shock” of new therapies hitting a large population for the first time, and perhaps we’ll be able to distinguish that in the coming years.
Now, though, we turn from the real-world results to the world of big talk. I wrote here three years ago about Patrick Soon-Shiong and his talk of his “Cancer Moonshot 2020” that he began publicizing in 2016. The phrase “covered in heaps of glittery hype” showed up in that post, among other unkind phrases, so now that it’s 2020 already, perhaps it’s time for a look at how things are going. Not well.
Four years later, independent medical researchers say they’ve heard virtual radio silence from Soon-Shiong’s initiative. And a review by STAT of clinical trial listings, research presentations, and press releases suggests the effort has fallen far short of its major goals. . .The initiative’s website went dark this past spring, and its social media accounts haven’t been active in nearly three years. Its original Twitter account — abandoned after the initiative changed its name in 2017 — is now littered with dozens of posts promoting free Amazon gift cards.
That whole Stat post is well worth a read. I especially liked the part where its author, Rebecca Robins, contacted 17 of the people who were quoted in the original 2016 press release showering praise on the whole idea, and found that none of them seemed to be available for comment. That tends to happen with these things – longtime observers may remember FDA commissioner Andy Eschenbach talking in 2003 about “eliminating death and suffering” from cancer by 2015, and people didn’t return calls about that one, either. It’s not just cancer, either: in 2013, then-Prime Minister David Cameron was talking about a cure for Alzheimer’s by 2025, and good luck getting him to go on the record about it these days.
This kind of high-level hand-waving about major medical problems that just has to be recognized, avoided, and discounted when it shows up. I’m all for ambitious goals – honestly, you should see the sorts of things I’ve been working on over the last ten years – but what I support is getting to work on them, not holding press conferences where you discuss how great your press release is. And how great a person you are for telling everyone about it. Clapping your hands and wishing for great results doesn’t get you very far – use your hands instead to put on a lab coat and pick up a flask or an Eppendorf vial. Use the time you’d spend coming up with a spiffy acronym and read the damned literature instead. Try to think up some useful experiments; that’s a lot better use of your brainpower than designing a logo for your initiative’s glossy web site.
In other words: the people who spend lots of effort telling you about the great things they’re going to do usually get lapped by the people who are actually working on the problems. How much of that drop in the cancer death rate is due to Patrick Soon-Shiong?