Re: Vitamin A Analogue for Breast Cancer Prevention: a Grade of F or Incomplete?

Extract

We were annoyed by the disparaging title given to the editorial written by S. Piantadosi (1) on our breast cancer prevention trial with fenretinide, which was published in the November 3 issue of the Journal (2). First, we feel that the title is not consistent with the editorial content itself (who gives an F grade to a “well designed and conducted study”?). In addition, the title is in sharp contradiction with Journal policy to publish only articles of major importance. Our disappointment was increased after learning that, as a result of this title, several media outlets have dismissed our study as being one of poor quality. In the current publicity-dominated era, the choice of this title is at best unscrupulous, if not dictated by reasons that have little to do with science.

It is a shame that the irresistible temptation of adding a sensationalist title has overcome a more reasonable review of our study, while we think we have honestly addressed the limitations of our work in the paper. Contrary to Dr. Piantadosi's doubts, we had clearly stated in the article that, among the dozen possible interactions, we tested only the one between fenretinide treatment and menopausal status because this interaction has strong biologic support. This support came not only from our previous observations that plasma insulin-like growth factor-I (IGF-I) levels behaved with the same pattern following fenretinide treatment [refs. (27) and (28) of our paper], but also from the well-established notion that premenopausal and postmenopausal breast cancer are different diseases that receive different treatments and have different risk factors, some of which, like body mass index, interact in a qualitative manner with menopausal status [refs. (39-41) of our paper].