Roller Coaster Ride

After the Times article ran, researchers at the National Cancer Institute tried in vain to duplicate the results obtained in Folkman's lab.

Negative press coverage of this failure was then turned upside-down by the revelation that some researchers finally had gotten similar results. The press was Folkman's friend again, though he says very little had actually changed.

On Feb. 12, 1999 the Times published an article describing the new success, and Folkman's cause received renewed attention from biopharmaceutical companies, universities and other research institutions worldwide.

Folkman says he believes part of the problem in responsibly reporting the results of scientific research is the intrinsic challenge facing journalists who specialize in science when they deal with medical issues.

"Science writers serve a very important function, which is to translate advances in science for the public, which is paying for that in grants," he says. "The only difficulty is that when research comes close to moving from the laboratory to patients, it can create raised expectations and let people down."

Folkman explains that although lab research with angiogenesis drugs has already obtained favorable results, it will most likely take several years to receive FDA approval, with additional time for manufacturing and distribution.

Still, since it takes an average of 15 years for experimental drugs to make it out of the lab and to patients, Folkman's endostatin is tantalizingly close to distribution.

In fact, according to the Pharmaceuticals Researchers Manufacturers of America, only one out of 1,000 compounds tested make it to clinical safety trials in human subjects. Of those, approximately one out of 20 become FDA approved.

"A cancer patient whose tumor is not responding to conventional therapy can go into clinical trials of new drugs, but there are sometimes waiting lists and shortages," Folkman says. "Whenever lab discoveries come close to application, you have to be super-extra careful...because media coverage can increase expectations."

Dealing with the Media Blitz

Donald E. Ingber, an associate professor of pathology at HMS and a research associate in pathology and surgery at Children's Hospital, has worked with Folkman for 15 years and has had a front-row seat during the recent media events.

"The media may be trivializing [Folkman's] contributions by putting all the pressure on one compound, endostatin, to be a silver bullet in the clinic. This is unfair," he says. "[Folkman's] contributions to both angiogenesis inhibitors and stimulators in clinical trials cannot be underestimated."

Ingber adds that to him it seems the media flurry surrounding endostatin trials and Folkman's recent work is attributable at least in part to the perceived novelty of the results.

"The media all report news in relation to these new drugs as if they are hearing it for the first time, which they of course are," he says.