During a state of political polarization so extreme as the one in which we live today there are not many agreements on hot button topics, such as the news, between both sides. Despite the rarity of these situations, one that shows up consistently is the media’s ability to use facts, scientific or otherwise, and narrative to push a particular objective or speak to a certain audience. This is often used to promote political agenda but is also present in the field of medicine to express one’s perspective on treatment data; this is the case with the relatively recent approval and employment of gilteritinib (branded Xospata), a pill developed by Astellas Pharma to combat the FLT3 Acute Myeloid Leukemia (AML) mutation. With the official lab report data in one’s pocket, topics such as this can be reported on using various rhetorical patterns, thus guiding the message of a piece. This is evident with how a CNN health post and a segment on cancernetwork.com review the impacts of gilteritinib on AML cases, using the source paper published by those who conducted trials on the drug.

CNN is currently one of the most prominent national and international media outlets and disputedly ranks with Fox News as highest in political bias on a consistent basis, though this statement stands irrelevant when discussing gilteritinib and AML, as it is not a very politicized subject. This does not, however, rule out the featured article using experimental data to create a narrative—even if it is well-meaning. The first step in analyzing the position and communicative strategies of the article is to note the title; the title of CNN Health’s piece is as follows: “New drug represents ‘paradigm shift’ in treatment of acute myeloid leukemia.” The phrase “paradigm shift” suggests dramatic effects of the cancer drug, provoking interest and a sense of hope from the reader. In addition to the article’s title, it is worthwhile to learn who the author is and his or her relation to its topic. A woman by the name of Susan Scutti is credited for writing this segment; the website lists her without a prefix or suffix, indicating she does not carry a doctorate, nursing license, or perhaps even have any significant experience in the field of medicine. In contrast, the report from which Scutti based her article on lists not only the lead doctor of the trials, but thirty others of the same stature as well. This is important to realize as a consumer of information regardless of the topic, as it can be used to gauge an author’s reliability. A strategy used not only in this article, but in other secondary sources as well, is the converting of data and terminology into lighter, more easily ingested information for a broader audience; this is seen with Scutti’s reference to gilteritinib as “more effective and less toxic” than chemotherapy treatments, contributing to “an overall positive result” in the clinical trial; in the document published by The New England Journal of Medicine the reader is met with verbiage along the lines of “salvage chemotherapy group” and “thrombocytopenia” (Perl et al.). The same is observed when comparing “a 36% reduction in risk of death” (Scutti) and “hazard ratio for death, 0.64; 95% confidence interval [CI], 0.49 to 0.83; P<0.001)” (Perl et al.)—there is a clear reduction in technicality based on the audience the writer intends to address; Scutti speaks to any party interested in cancer research and treatment development, whereas the NEJM report is designed for more medically literate consumers. Not having an expert understanding of AML, the drug, and its effects might cause a consumer to be more optimistic. A final feature of the CNN’s “paradigm shift” article is the author’s inclusion of comparison to build relatability with the reader. When explaining to the reader the effects of gilteritinib, Scutti describes it as “similar to a car that races forward without stepping on the gas pedal… [it] essentially stops the fuel from getting to the engine by directly targeting the gene.” This metaphor is credited to Dr. Alexander Perl, the aforementioned lead on the trials. The inclusion of this bit illustrates to the reader how the pill works, once more relating with viewers and straying from the facts-only format of the original essay. In sum, Scutti wrote for CNN with the purpose of simplifying the work performed by Dr. Perl and others to establish the efficacy of gilteritinib on AML and the odds of relapse, all the while connotating the data to induce hope and optimistic views of the treatment.

The tendency to use experimental data in ways other than originally intended is common in news media, but it is not uncommon for online publishers to write pieces summarizing said data as well. This is often seen as a service to a broad audience on popular problems or societal concerns (e.g. cancer and treatment progress). An article by Kristie L. Kahl on cancernetwork.com does just this; though the author is not credited with any medical or professional accolades, she writes on the processes and results of Astellas’ ADMIRAL trial that used gilteritinib to combat the relapse/refraction of FLT3 AML. The author does this in a way which, rather than generalizing and making the data more palatable to the average tabloid reader, briefs the consumer on the overall facts of both that trial and a similarly intended one as well. Kahl mirrors Astellas with the inclusion of specific statistics that reflect sufficient knowledge of the subject; the author makes mention of gilteritinib “demonstrate[ing] significantly longer median OS compared with chemotherapy (9.3 months vs. 5.6 months, respectively; HR, 0.64; 95% CI, 0.49-0.83; P>.001)” in addition to other similar figures in the same paragraph. This is merely the condensation of the data given in the original report, communicating just how much the pill affects survival rates. Though not written by a medical expert, Kahl’s “Confirmatory Trial of Gilteritinib Meets Primary End Point of Improving OS in Relapsed/Refractory FLT3+ AML” cites the senior vice president of oncology development at the company that carried out the trial: Andrew Krivoshik, MD, PhD. The author includes Dr. Krivoshik’s testimony as to the purpose and accomplishments of the trial, establishing credibility she does not have from her own knowledge alone. This is akin to the way the source article includes a generous list of names of contributors in the trials—both instances of crediting these experts ensures the content is received as trustworthy. Despite the length difference between this summary article and the source publication, Kahl ends the piece with a borrowed quotation: “Treatment options for patients with relapsed or refractory FLT3-mutated AML are largely limited to various salvage chemotherapy regimens, and there is no consensus regarding an approach… We found that in this population of patients, gilteritinib resulted in superior overall survival and percentages of remission as compared with salvage chemotherapy” (Perl et al.). This statement brings the writer’s post to a close, bringing the reader back to the hypothesis of the experiment and concluding its success after being briefed on essentially all of the primary points of the original article.

We live in a world which provides all access to information on most any subject. The way in which said information is redistributed often depends on the agenda of those with the power to do so; this is indisputably seen in how different news stations describe current events, regardless of political affiliation, occurring in the scientific world just as much as any other. Though data is sometimes spun in a way to advance one party over another, it can also be to serve different audiences well; this is the case with both articles by CNN and NEMJ with regards to a study conducted by associates of Astellas Pharma. In CNN’s piece, the information is conveyed to reach the hearts and minds of a common audience with more interest than topical knowledge; as for the Medical Journal, the author just clumps the source’s data into an easier read so that those in the field or attached to it in some way may still have a complete understanding. With both publications, audiences are served positive news on a topic that impacts a great many people, acting as extensions of the very group that conducted the research.

 

 

 

Works Cited

Kahl, Kristie L. “Confirmatory Trial of Gilteritinib Meets Primary End Point of Improving OS in Relapsed/Refractory flt3+ AML.” Cancer Network, Cancer Network, 31 Mar. 2021, https://www.cancernetwork.com/view/confirmatory-trial-of-gilteritinib-meets-primary-end-point-of-improving-os-in-relapsed-refractory-flt3-aml.

Perl, Alexander E., et al. “Gilteritinib or Chemotherapy for Relapsed or Refractory FLT3-Mutated AML: Nejm.” New England Journal of Medicine, 4 Nov. 1970, https://www.nejm.org/doi/full/10.1056/NEJMoa1902688.

Scutti, Susan. New Drug Improves Survival for Certain Acute Myeloid … – CNN. https://www.cnn.com/2019/04/01/health/gilteritinib-acute-myeloid-leukemia-aacr-study/index.html.