Science never seems to move fast enough: Every day, people die of diseases we have known about for decades or centuries but haven’t been able to cure. A massive effort is afoot to speed the development of cures, often focusing on narrowing the gap that exists between basic research and the creation of useful treatments. But do we sometimes move too fast?
A striking pair of essays published last Monday in the journal Nature reveal how an exciting field of science, riding a wave of tremendous hype, can also be pushed prematurely into treatment — sometimes by preying on the hopes of desperate families.
“The fact there are diseases that are uncurable today, to me does not lead to an implicit authorization for trying anything and especially any stem cell,” said Elena Cattaneo, an Italian stem cell scientist at the University of Milan, who co-authored one of the essays. Cattaneo won international recognition this year for her advocacy against an Italian foundation that was pushing forward to treat terminally ill patients with a range of diseases with stem cells, despite having no credible evidence that its treatment worked.
“This word, ‘stem cell,’ is sort of magic, and it has hit so much the general imagination that we are responsible for being hyper-careful,” Cattaneo said. “Of course, science has to deliver things once there is good preclinical evidence, a good rationale.”
Cattaneo said it is often difficult for scientists, who would far rather spend time at the bench doing research, to be motivated to engage with the public. But during the past few years, she estimates that she and colleagues have lost 60 to 80 weeks of scientific research time in their efforts to protect patients from the false promises of bad science and to convince politicians that therapies tried in patients should be backed by rigorous evidence. Problems with the research from the Stamina Foundation are particular to the situation — including that the US patent office had rejected its application because the technique was unlikely to produce the cells of interest. But they also highlight a broader issue, also mentioned in the second essay — the rush to test promising approaches in people when they have captured wide public attention and hope.
Cattaneo said this problem has occurred in multiple areas in the high-profile field of stem cell medicine.
“There are too many clinical trials in my view that do not make any sense, that are not supported by strong science, and not supported by a strong rationale,” Cattaneo said. “To inject these cells into patients; I think this is a big mistake and we will all pay for that.”
For example, Cattaneo mentioned 2001 research, which used bone marrow cells to repair the hearts of rodents, from the lab of Dr. Piero Anversa, a Brigham and Women’s Hospital anesthesiologist. That paper rapidly led to such cells being tested in people. Three groups of scientists published work shortly afterward showing flaws with that initial finding, but now such cells have been injected into hearts of hundreds of patients — with mixed results but no overall clear signal of benefit.
Cattaneo said that the difficult part for scientists is that the excitement is largely justified: stem cells are one of the most exciting and rapidly changing areas of biology. The medical potential is big. But she worries that premature hype and use of these cells before they are understood will damage the field.
It may be urgent not only to protect the public from bad science, but also to protect good science from the perception that it is nothing but a bunch of charlatans in lab coats.