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Out of Order: Good news and good luck
July 2012
by Randall C. Willis  |  Email the author

My wife refuses to watch the news. Any news. She will not watch it on TV. She will not radio it free. She will not read even online. She will not view it any time.
It's not, you understand, that she would prefer to be ignorant. She is one of the smartest people I know. She's just tired of bad news—and that is something of which we never seem to run out. So I have taken it as my responsibility to try to find something good to say about the evening news or online papers or whatever source. My inability to provide daily enlightenment, however, sadly proves her point.  
Interestingly, the opposite seems to be true these days in the pharmaceutical market. Don't get me wrong; I have read plenty of stories about layoffs and dried-up pipelines, but the early days of summer are a special time—a time when good news runs rife through the press releases, a time when hope is boundless, where seldom is heard a discouraging word and the skies are not cloudy all day. The early days of summer start the latest phase of conference season.  
At conferences like those put on by the American Society of Clinical Oncology (ASCO) and the American Diabetes Association (ADA), we learn just how close the latest drugs are to being launched onto the medical landscape, how compounds are one or two tests away from proving broad efficacy, how the long-term safety data and post-hoc analyses have borne out the earlier contention of a drug that is safe and well-tolerated.  
And I, along with everyone else, applaud the success and effort that went into realizing these achievements. With news like this, you should crow. Be proud of yourselves for your achievements.
At the same time, however, I wonder about what information is missing. What about the trials that showed drug X was inferior to the current standard of care? Or the diagnostic tests that showed although patient disease improved on drug Y, it did so at the expense of a diminished quality of life?
Now don't send out a lynch mob or give Oliver Stone my phone number. I am not suggesting that anyone is purposefully hiding negative data that could endanger patient lives or falsely improve corporate bottom lines. It is human nature to shout loudly in the face of success and to retrench and rethink in the face of setbacks.
But from a medical and scientific perspective, it is vitally important to know and try to understand all of the data involved in the pursuit of a new drug or therapy. Only hearing about the successes gives us a skewed sense of what is going on and could potentially open us up to running into the same problems time and again.
When we're talking about bacteria or cell cultures in Petri dishes, this is merely an annoyance and an expense. When we're talking about patient involvement in future clinical trials, then the gravity of the risks amplifies.
I appreciate that to some readers, this position will seem incredibly naďve. In a world of instant investor gratification, even a sniff of bad news could send a company's stock reeling. I understand the quandary in which companies find themselves, but I have to believe there is a way to share unappetizing results without it being seen as a failure, of the product or the company.  
It's not as though the information doesn't get out there of its own accord, whether through conversations over drinks at side-symposia, or through former employees discussing projects on which they worked. To get ahead of these conversations by sharing results voluntarily affords companies the opportunity to ensure the information is presented fairly and in context. Which conversation sounds better?
"Did you hear there were safety issues with candidate B? Apparently, two patients died," or, "The candidate B trial was temporarily halted so that we could understand the deaths of two patients in the treatment arm. Analysis showed, however, that the deaths were not treatment-related."  
The same data—but totally different interpretations and outcomes.
Bad news isn't inherently bad just because it's not what we expected or wanted, and it should be allowed to inform our subsequent decisions just as much as the good news. We're just going to have to learn to discuss it like adults.  
In the meantime, I'll see what I can do about getting my wife to learn about the Ontario budget, fires in North Tonawanda and the latest nonsense from Lindsay Lohan.  
Formerly the executive editor of ddn, Willis has worked at both ends of the pharmaceutical industry, from basic research to marketing, and has written about biomedical science for almost two decades.



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