Comments on: Lead author of major breast cancer study announced at ASCO co-authored two corrected papers with Anil Potti

By: Marco Berns

Marco Berns — Wed, 06 Jun 2012 09:36:32 +0000

Surely we can find a more realistic version of “We’ve envisioned a world where cancer treatment would kill the cancer and not hurt the patient” in the late 5th century before the Christian Era (BC)?

For example: http://en.wikipedia.org/wiki/Hippocratic_Oath

“I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone.” Of course English did not exist at that time.

This is reiterated a little later in the same oath:
“In every house where I come I will enter only for the good of my patients, keeping myself far from all intentional ill-doing and all seduction and especially from the pleasures of love with women or with men, be they free or slaves.”

My understanding is that in the ancient world prudishness was absent, that people were seen as objects to be bought and sold (perhaps still are), and society depended on personal loyalties. The reference to sex, some of which is thought by many to be unorthodox (doctors were predominantly men) may be a reason modern people find that section of the Hippocratic oath disturbing. I think that it show that Hippocrates was addressing the problems of his society, and that those were things that were facts of life. Greeks, under the Mediterranean sky, especially towards dusk, or bathed in the light from olive-oil lamps, can be extremely pretty and were objects which could be misused. It is a known fact. The Hippocratic oath, rather than being quaint, is a social document.

When people from drug companies speak they might mention the problems encountered every day such as price gouging, or lack of transparency about how much things really cost.

http://www.palgrave-journals.com/biosoc/journal/v6/n1/full/biosoc201040a.html

Why don’t they make statements in some modern version of the Hippocratic oath about avoiding price gouging? There are echos of this in a new version of the Oath (2010), in fact about a third of the text, and the main thrust of the document. Oxford Handbook of Clinical Medicine. 8th Edition. OUP. 2010. Page 1.

The most relevant are:

“I will not put profit or my own career above my duty to my patient”.

“I will do my best to keep myself and my colleagues informed of new developments, and ensure that poor standards or bad practices are exposed to those who can imporve them”.

“I will promote fair use of health resources and try to influence positively those whose policies harm public health”.

“I will learn from my mistakes and seek help from colleagues to promote patient safety”.

By: Fernando Pessoa

Fernando Pessoa — Tue, 05 Jun 2012 14:39:36 +0000

“We’ve envisioned a world where cancer treatment would kill the cancer and not hurt the patient” is mundane wish-list, not hypothesis. Certainly “the vision thing” though.

“Wer Visionen hat, soll zum Arzt gehen.” = “Whoever has visions, should go to the doctor’s”. So spake Helmut Schmidt, Germany’s most popular post WWII chancellor, in 1980.

http://de.wikiquote.org/wiki/Helmut_Schmidt

By: Ginsberg

Ginsberg — Tue, 05 Jun 2012 14:25:35 +0000

“and this discovery was truly remarkable.” RED FLAG!

Compare this to the way Watson and Crick handled their paper on DNA structure. “This structure has novel features which are of considerable biological interest.” After presenting their proposal for the structure they said, “It has not escaped our notice that the specific pairing we have postulated immediately suggests a possible copying mechanism for the genetic material.” It seems as though comments like “truly remarkable” would have been inappropriate if made by the scientist who made the discovery.

By: chirality

chirality — Tue, 05 Jun 2012 13:28:22 +0000

“We want to be clear: Despite the fact that work by Blackwell and Potti has been found to have flaws, that doesn’t mean everything Blackwell ever works on needs to be scrutinized more carefully, forever.”

A clever statement. A reader might be left to wonder what would be an appropriate period during which Blackwell’s work should be scrutinized more carefully.

By: Elaine Schattner, M.D.

Elaine Schattner, M.D. — Tue, 05 Jun 2012 12:59:22 +0000

Ivan,
I can’t speak for the EMILIA researchers. i find the clinical data on T-DM1, as presented, impressive in terms of a single drug’s activity, and lack of toxicity, in women with metastatic Her2+ breast cancer that progressed with other treatments.

It’s a shame if Blackwell’s work is possibly “contaminated” by association. Unlike benchwork, multi-center clinical trials like EMILIA are closely and independently monitored. So I think it’s unlikely the data presented are untrue.

I blame the media, too, for using such fabulous, “expert” quotes. The data should speak for itself.

By: Lynnepi

Lynnepi — Tue, 05 Jun 2012 12:22:35 +0000

“We’ve envisioned a world where cancer treatment would kill the cancer and not hurt the patient … and this drug does that.” That is so irresponsible! It also highlights Dr. Blackwell’s bias or inability to place the evidence in the “appropriate skeptical perspective.” I don’t think Duke learned anything.

P.S. Agree with you, amw – 2 correlation coefficients for 1 relationship between two variables? Doesn’t make sense.

By: amw

amw — Mon, 04 Jun 2012 23:26:20 +0000

The correction to the JCO 2008 paper (http://jco.ascopubs.org/content/29/27/3721.1.full.pdf) appears innocuous at first sight but has weird features. It contains three separate corrections – odd in itself. The first and major correction seems to make no sense at all: the correction states that two variables are correlated with each other (not with a third variable), but each one still retains its own r and p value – this makes absolutely no logical sense at all. Correlation between two variables should have a single r value and p value, not separate values for each variable. And the mistake is then repeated.

I have to say I no longer have any trust in JCO corrections / expressions of concern after the journal’s handling of the Roman-Gomez fabrication – plagiarism cases:
http://retractionwatch.wordpress.com/2012/04/05/jco-expresses-concern-over-western-blots-from-spanish-group-that-had-aroused-earlier-concern. One gets the feeling that the authors could say that lymph node status is associated with the diameter of Uranus’ moons and no one would actually notice. The corrections are clearly not actually refereed by scientists.