Viewpoint: Why cancer centers 'sell out' science when promoting clinical trials as treatment

When cancer centers advertise clinical trials as cancer treatment through nationwide billboard and radio campaigns, they betray ethics and science, potentially giving patients false hope for successful treatment, two ethics professors argue in a STAT op-ed.

Jonathan Kimmelman, PhD, associate professor and Biomedical Ethics Unit at Montreal, Canada-based McGill University and Alex John London, PhD, professor and director of the Center for Ethics and Policy at Pittsburgh-based Carnegie Mellon University, highlight the ethical issues surrounding advertising clinical trials as treatment and how these campaigns are often misleading to patients.

Here are five takeaways from the op-ed.

1. The authors provided several examples of cancer treatment centers promoting clinical trials, including Houston-based MD Anderson Cancer Center, which advertises clinical trials alongside immunotherapy and proton-beam therapy as one of the various ways of "fighting cancer," and Boca Raton, Fla.-based Cancer Treatment Centers of America, which promotes clinical trials as part of its "commitment to bringing our patients new and innovative cancer treatment options."

2. Cancer treatment centers spend approximately $173 million on advertising annually, the authors noted, competing for patients by serving up a menu of clinical trial options and suggesting that their participation in these trials may give them an edge on their care. "This messaging is not only misleading but also undermines the very norms of science that clinical trials — and cancer centers themselves — are supposed to advance," the authors argue.

3. Additionally, the authors noted numerous ads imply that because all significant treatment breakthroughs were initially given to patients in clinical trials, patients who participate in trials have access to these breakthroughs. "It's like saying that most people who win the lottery buy their tickets at convenience stores, so buy your lottery tickets at a convenience store so you will win the lottery," the authors noted.

4. When ads suggest trials give patients "an edge" on their treatment, they conceal the fact that a number of new drugs are no better than standard care and are sometimes unacceptably toxic, the authors added. "In addition, trials often entail more frequent visits and potentially burdensome research procedures like organ biopsies," the authors wrote. "It also hides the fact that patients in trials are often randomized to control arms that allow scientists to compare novel treatments to the standard of care."

5. To solve this issue, the authors offered three suggestions: healthcare organizations should regard all public messaging as part of their duty to give patients reliable and accurate information by vetting proposed clinical trial ads, professional societies and patient advocacy groups should distribute guidelines on clinical trial advertising and government agencies such as the FDA should consider regulating clinical trial ads.

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