Page 3 of this past week’s Boston Globe Magazine featured a full page ad for Mass General. It was a single white pill on a blue background with the headline. “Sometimes the smallest cancer treatment…(picture of pill)… offers the greatest promise”
A few tiny pills are changing the way we think about cancer.
At the Massachusetts General Hospital Cancer Center, we are pioneering efforts to match smart drugs to a cancer’s specific genetic mutation — to slow the cancer’s growth — and in some cases, reduce it significantly. We know that our patients are unique and so are their tumors. Now their treatment can be, too.
Some of the drugs are approved; others in clinical trials. The question some medical ethicists pose is: is it appropriate to call clinical trials “treatment?” Aren’t patients in clinical trials – especially trails with a placebo arm – better referred to as “research subjects”? This debate has generated this bit of jargon:" the therapeutic misconception."
See the .pdf here for more on that.
Some patients want the opportunity to participate in a trial. But, should research be used as advertising? It does not seem uncommon.The NYTimes ran a story on the topic in December:
One of their examples? MGH’s ads for their cancer program.
The ad promoted Mass General’s genotyping research program, which tests lung and colon cancers for genetic mutations that may respond to novel drugs aimed at specific molecular targets.
But the ad did not explain that some patients might be treated with existing drugs while others would have to enroll in a clinical trial to be eligible for the experimental drugs…
Mass General’s review board, for example, has guidelines saying that recruitment ads for research subjects should prominently display the word “research” and should not " ‘hype’ the study."
But medical centers typically do not ask their review boards to vet ads that promote the general idea of access to clinical trials.
Perhaps informed consent is key. But can an ad campaign deliver all the information patients or subjects need to decide whether to participate in a research study?
Here’s the fine print from the hospital’s web site:
To be eligible for molecular fingerprinting (also referred to as “genotyping”) at the Massachusetts General Hospital Cancer Center, you must be a current or prospective patient at the Cancer Center with melanoma, leukemia, brain or metastatic breast cancer, or a metastatic adenocarcinoma that started in the lung, colon or rectum. A typical lung cancer patient appropriate for this type of genetic testing is a non-smoker or someone with a past light smoking history. Most individuals with these types of genetic mutations present with lung cancer at a younger age than typical lung cancer cases, and are otherwise healthy. Although there seems to be a “patient profile” for lung cancer patients, there are no known attributes that are commonly seen in colorectal, breast cancer, melanoma or leukemia patients.
If we find a genetic mutation in your tumor that can be treated with targeted therapy (“smart drugs”), your physician will discuss this option with you. This may involve enrolling in a clinical trial since many smart drugs are quite new. Currently, we are testing tumors for over 130 different mutations, and using smart drugs to treat some of them. Your tumor sample will also be kept on file so it can be re-tested if new mutations, and smart drugs to treat them, are discovered in the future.
Coming up next week: Reality TV as Marketing.