OBR OncologyMinimizing Toxicity in Conference Abstracts May Undermine Cancer Care, Data Suggest

The Risks of Understated Language in Oncology: How Minimizing Toxicity Descriptions in Research Impacts Patient Care

In the realm of cancer treatment, the accuracy and clarity of conveying treatment toxicities in research publications hold paramount importance. A recent systematic review of conference abstracts from major oncology/hematology conferences reveals a concerning trend: the use of subjective, minimizing language like “safe” and “well-tolerated” when describing treatment toxicities. This practice not only potentially misleads treatment plans but also may significantly impact patient care, challenging the integrity of clinical communication in oncology.

Key Points:

• Study Overview: Abdel-Azez Abusamak, MD, and colleagues analyzed 34,975 abstracts from ASCO, ASH, and ESMO conferences over three years, uncovering frequent use of minimizing language regarding treatment toxicity.
• Prevalence of Minimizing Language: Out of the analyzed records, 5,299 (15.2%) used subjective language that downplayed toxicity, often in studies with severe or even fatal adverse events.
• Phase Trials Analysis: The majority of these studies were phase 1 trials (45.5%), followed by phase 2 (29.6%) and phase 3 trials (7.4%).
• Adverse Events Reporting: Abstracts with minimizing language reported 62.6% grade 1 and 2 adverse events (AEs), 78% grade 3 and 4 AEs, 8.8% grade 5 AEs (death related to an AE), and 11.4% discontinued due to AEs.
• Impact on Patient Experience: The use of minimizing language can obscure the severity of adverse events, potentially affecting patient quality of life and treatment decisions.
• Call for Accurate Language: Experts advocate for eliminating subjective terms in describing toxicities, emphasizing the need for clear, data-driven communication about both efficacy and toxicity in clinical trials.
• Influence of Pharmaceutical Companies: The study points out the role of press releases by pharmaceutical companies in shaping the narrative, often leading to understated descriptions of toxicities.
• Proposed Solutions: Dr. Al’Hadidi suggests implementing technology to bar the use of minimizing language in abstract submissions and calls for more intensive educational efforts on this issue.

Imagine if we were to describe efficacy data as ‘acceptable’ or ‘tolerable’ instead of providing the exact data. In clinical trials, we need to become as data driven to discuss toxicity data as we are with efficacy data.
– Nicole Kuderer, MD, Medical Director of the Advanced Cancer Research Group in Kirkland, Washington

More on Adverse Events