Wikipedia:Mediation Cabal/Cases/2010-08-20/Sipuleucel-T

Where's it
Provenge

Involving who

 * User:SaulK
 * User:Nbauman

Details
I have several friends with prostate cancer. The FDA has just approved the first cancer immunotherapy vaccine and it happens to be for prostate cancer. The treatment approval was heralded by the medical community as a significant breakthrough in cancer treatment, since researchers have been trying for decades to succeed in training the patient's immune system to attack cancerous cells--and Provenge is the first treatment to succeed and gain regulatory approval. Provenge was almost immediately accepted by the NCCN as first line treatment for advanced PC, and ASCO has strongly supported Medicare coverage for Provenge treatment to the CMS. The study which resulted in FDA approval was just published in the New England Journal of Medicine. Provenge significantly extended the lives of treated patients. The median extension of life was 4.1 months. At three years the Provenge group had 32% still alive and the "placebo" group 23%. This latter figure may understate the treatment effect, since patients were allowed to cross over to Provenge after their disease progressed--and 67.3% of placebo patients elected to do so. While the placebo cross overs vs. those who did not cross over was not randomized and thus was stated to require further study, the NEJM article did report that the "pure placebo" patients, who did not ever receive Provenge, only lived a median of 11.6 months vs. 25.8 months at median for the treatment group. The simple math says the treatment group advantage over "pure placebo" was 14.2 months. I have tried several times to post an accurate "Provenge" entry setting out these facts, which are all verifiable from authoritative sources. I have also tried to explain in the entry the significance of the distinction between "median" and "mean", since the 4.1 month median life extension by Provenge is the halfway point in a series of numbers and not, as has been repeatedly inaccurately reported, the "average life extension". In fact, examining the graphs in the NEJM article clearly shows many men lived years longer than their life expectancies by Halabi nomogram. I have further tried to include the advantage over "pure placebo" data that is plainly set out in the NEJM article. Nbauman in each instance has reverted my edits back to a version he wrote which is slanted and inaccurate. His version originally referred to "average life extension", removed all references to the distinction between "median" and "mean" (which he does not seem to understand), removed any reference to the treatment being a breakthrough--in spite of multiple sources characterizing it that way--and similarly removed all references to "significant" life extension, apparently substituting his inexpert judgment that "just" 4.1 months is not "significant", for that of again multiple authoritative medical sources pointing to the life extension achieved as the largest EVER in this patient population. He has also objected to the inclusion of the 14.2 month figure above ostensibly because my doing the math that 25.8 minus 11.6=14.2 is an unallowable "interpretation" of data, rather than a neutral statement of the same. I don't exactly understand what source I am supposed to cite for the proposition that 25.8-11.6=14.2. In any event, I am only trying to post an accurate entry, and despite repeated exchanges in talk in which I have set out for him where he is wrong, he just goes and restores his earlier inaccurate version. I hope you will help resolve this.

Mediator notes
I will mediate this dispute, if acceptable to the parties. Hipocrite (talk) 14:05, 4 October 2010 (UTC)
 * As neither editor in the dispute appears to be currently active, I have marked this as closed. I will happily mediate if the editors wish to do so - please contact me and I will reopen the case. Thanks. Hipocrite (talk) 13:11, 7 October 2010 (UTC)