The Real Story On Page One


Leonard Zwelling

         This story appeared on page 21 of the NY Times on Saturday, September 26. It reports on favorable trial results
against renal cancer using a check point inhibitor (nivolumab) in one trial and
cabozantinib, a tyrosine kinase inhibitor, in another. In the more dramatic
finding, the first trial had to be stopped early as the results were clearly
superior with nivolumab vs. everolimus. In this first trial, 20-25% of the
patients receiving the more experimental therapy responded and median survival
was 25 vs. 19.6 months with the everolimus. This is all out in the New England Journal of Medicine and is
clearly an important advance in a once uniformly fatal disease that has seen
seven new active agents identified in the past 10 years. Great!

         Is this the most important story of September 25? Hardly.

         In newspapers, the most important story appears above the
fold in the extreme right column of page 1. In both the NY Times and The Wall Street
, that story was the resignation of the Speaker of the House, not
only from the speakership, the number 3 position behind only the Vice President
in our government, but also from his seat in the Congress. John Boehner has
clearly had enough of being both the leader of the House Republicans and the
House Tea Party goers and for the good of the country he is stepping aside and
giving someone else a chance to wrestle the Republican caucus to the ground.
Perhaps Kevin McCarthy (just think, it could have been Eric Cantor) can get the
mountain lions herded. This is not likely given the mountain lions would sooner
see the government stop than actually negotiate with their Democratic brethren.

         And if the surprise resignation of Mr. Boehner was not a big
enough story for you, then surely the Pope’s first full day in New York would
suffice given the pomp, circumstance and general all around good feelings that
the trip engendered, even in the cynical Big Apple.

         I realize that the cancer trial results were exceptional,
but surely these results were not the most important news of the day. Kidney
cancer has not been cured and the majority of those afflicted with the disease
will still die from it.

         Thus, I ask you, why did these trial results appear above
the fold and on the right of the first page of the Houston Chronicle Saturday morning? Let me be the New York cynic
that I am. It is because Dr. DePinho has purchased the Chronicle. I believe that for the commitment to a continuing series
of full-page ads from MD Anderson, red line and all, the Chronicle in turn will create front-page news from page 20 material despite having called for a change at the top at Anderson as recently as April of this year.
I believe that this is all part of the plan to bolster the Allison claim to a
piece of this year’s Nobel Prize, which he probably deserves and will get
without the help of his newly found benefactor on the top of Pickens. Why does
The Ronald want that piece of metal from Sweden at Anderson? Because it likely
gives him a leg up on keeping his job, when everything else he touches is
turning to Swedish meat balls.

         It is a sad, sad state of affairs to watch the only daily
newspaper in the fourth biggest city in the country kowtow to the public
relations budget of one of the members of the Texas Medical Center. Along with
the constant din to promote commercialization that is rattling down the halls
of Anderson and poisoning the mission of the Texas Medical Center, the buying
of the press is an awful low blow to a great city.  

         I suggest that the few of us that still read the Chronicle give a great deal of thought
to canceling subscriptions and/or using it to wrap fish. I thought they were
just shutting me up and shutting me out. Now I know they are perverting the
real news in favor of the unreal type for money. Can DePinho as a guest on
cable news be far behind? Wait a minute. We did that already.

         Is there any wonder why people keep streaming to MD Anderson
as if it were Lourdes? After all, MD Anderson is making cancer history. The doctors there should be able to make YOUR cancer history, too. Unfortunately, that isn’t
quite the case and even in this valuable new trial the extension of survival by
nivolumab is limited and only 25% of the patients responded at all. Every bit
as important as the result that was touted is the answer to the questions of
why the drug wasn’t curative and why only a subset of patients responded.

         This is clinical research, research with patients, but
research nonetheless. Medical scientists are still searching. No cancer was
made history although a little bit of history was made. But the history of
September 25, 2015 should be dominated by the tan man from Ohio and the Holy
Man from Argentina.

         Page 21? The NY Times
got it just about right.

Leonard Zwelling