Respectful Insolence

I know I have readers who are neuroscientists. However, do I have readers who are currently attending the 4th Quadrennial Meeting of the Society of Neuro-Oncology in San Francisco going on this weekend? Why do I ask? Given the Regular readers might suspect that it has to do something with a man who has become a regular topic of this blog over the last two years. Yes, I’m referring to Stanislaw Burzynski, the oncologist who has never done a residency in internal medicine or a fellowship in oncology who was the subject of an excellent news report by Liz Szabo in USA TODAY one week ago today, the responses to which have ranged from the pathetic to the despicable, such as Eric Merola’s suggestion on Twitter (rapidly deleted but saved, thanks to Twitter notifications) that a certain critic of Burzynski whom we all know and (hopefully) love “find a gun & place in mouth.” Then, for pure, unbridled stupidity, it’s hard to beat Suzanne Somers, whose book Knockout devoted a whole chapter to praising Burzynski, who leapt into the fray to defend Burzynski a few days ago.

It’s probably a coincidence, given that these meetings were scheduled a long time ago, but since last Friday, the spin has been coming fast and furious out of the Burzynski Clinic. For example, on the very day that Szabo’s report was published, Burzynski issued a press release entitled Burzynski Clinic Presents Over Five Years Survival Data From Phase II Trials of ANP for Inoperable Brain Tumors at the Congress. Then, today at the poster presentation session at the Society of Neuro-Oncology meeting in San Francisco tonight between 7 and 9 PM he’s presenting two abstracts:

  1. NO-020 A Phase II study of antineoplastons A10 and AS2-1 in adult patients with recurrent glioblastoma multiforme based on Protocol BT-21. Gregory Burzynski*1,2, Stanislaw Burzynski1,2, Tomek Janicki1,2, Ania Marszalek1. 1Burzynski Clinic, USA, 2Burzynski Research Institute, USA.
  2. NO-021 A Phase II study of antineoplastons A10 and AS2-1 in pediatric recurrent diffuse intrinsic pontine glioma. Stanislaw Burzynski*1,2, Tomasz Janicki1,2, Gregory Burzynski1,2, Ania Marszalek1. 1Burzynski Clinic, USA, 2Burzynski Research Institute, USA.

OK, I don’t know whether Stan the Man himself will be standing in front of his poster for two hours, but presumably one of the authors will. In any case, now you know why I’m wondering if any of you are at the Neuro-Oncology meeting right now. Basically, I’d love to see what’s on those posters, as the abstracts (as most conference abstracts are) isn’t particularly helpful. No, I don’t want anyone to harass whoever’s standing in front of the poster, although if it is Burzynski himself real neurosurgeons, neuro-oncologists, and neuroscientists studying brain cancers are encouraged to grill him (politely and only about the science!) about his results and report back. If he’s passing out copies of his poster, as is often done at these conferences, please get a copy, scan it, and e-mail it to me. Sadly, I know it’ll be midnight here when the poster session in San Francisco is over, but that’s OK.

Because there isn’t (yet) a press release from the Burzynski Clinic about his results, let me just jump back to the first press release from the conference in China:

The Burzynski Clinic (BC) announced today that it made a keynote speaker presentation at the 2nd Annual Congress of Asia-Pacific Academy of Anti-Aging Medicine in Beijing, China. Based on the presentation in Beijing, a total of 401 eligible patients (patients who received over 28 days of treatment) with advanced inoperable brain tumors have been treated with antineoplaston A10 and antineoplastons AS2-1 therapy (ANP) in phase II studies. Most of the patients (87%) were diagnosed with high-grade tumors and the remaining patients were diagnosed with low-grade tumors. The patients were diagnosed by pathologists not associated with BC and objective responses were verified by Central Radiology Review. The group of 77 patients (19%) survived over five years from the treatment start. Of particular interest were results in patients with brainstem gliomas. The group of 17 patients with brainstem glioma underwent the treatment and 65% of these patients survived over five years. An additional group of 42 patients diagnosed with diffuse intrinsic pontine glioma (DIPG) have been treated and a total of 19% survived over five years.

The quality of survival is very good and there is no long-term toxicity related to ANP.

These clinical results are very encouraging, since they describe a positive ANP effect on some of the worst malignancies in the entire oncology field, but they will require FDA approval.

There are a lot of red flags here, of course, the first of which is that the conference is the Asia-Pacific Academy of Anti-Aging Medicine. Anti-aging medicine tends to be, more than anything else, a cesspit of pseudoscience and quackery; so Burzynski fits right in. But what about the report itself. Obviously, it’s pretty much impossible to tell much from a self-serving press release, but there is one enormous additional red flag. Notice how the press release says that this is a report on a “total of 401 eligible patients (patients who received over 28 days of treatment) with advanced inoperable brain tumors have been treated with antineoplaston A10 and antineoplastons AS2-1 therapy (ANP) in phase II studies.” Actually, there are two red flags right in that passage. First, notice how it says only patients who received over 28 days of treatment were counted. This, by its very nature, selects for patients who are in good enough shape to tolerate 28 days of antineoplaston therapy, which, as we have seen, is highly toxic, Burzynski’s claims otherwise notwithstanding. Normally, the way good clinical trials are done involves an “intent to treat” analysis, in which every patient randomized is counted, including patients who could not tolerate the therapy and had to stop. That way, this selection bias is minimized. Think of it this way. If a patient has to stop therapy due to lack of tolerance or clinical deterioration, that counts as a patient for whom the treatment didn’t work. Now, this can be acceptable if the number of patients who didn’t receive over 28 days of treatment were stated, but it didn’t. That number is mandatory in any such report.

The second big red flag is the design of this study. This is not a single phase II study. Basically, from the report, it appears to be nothing more than Burzynski conglomerating all or some of his phase II studies into one big undifferentiated glob of patients and then reporting on them. Sorry, Stan, but it doesn’t work that way. You have to report each phase II study individually. Grouping them all together like this, particularly when we don’t know how he picked which studies he was going to group together, is complete nonsense. It’s meaningless drivel. Add to this the fast and loose way that Burzynski plays with patient records and has been found by the FDA to destroy original patient records, and there’s no reason to believe the validity of any of his report from China, and I don’t feel like spending any more time, except to note that Burzynski states that there are no “chronic toxicities.” Of course, we all know from Szabo’s report that there are a lot of acute toxicities from antineoplastons, including hypernatremia (sodium levels too high).

Moving on to the two posters, let me just say one thing that needs to be understood by the non-scientists who read this blog. Poster presentations are the lowest form of published scientific discourse. They get you an abstract, some exposure at the meeting if people are interested in your poster, and that’s about it. They’re also subject to the weakest peer review. For some meetings, pretty much every abstract is accepted. The good ones or the ones covering the hottest topics are accepted for oral presentations, such as plenary session talks (the best!) or talks in various parallel sessions (good but not as good as the plenary session). All the rest are relegated to poster presentations, and that’s where Burzynski is.

Now let’s look at Burzynski’s abstracts, which I’ll basically treat as the same thing, because, well, let’s face it, they are the same thing. The first one is NO-020:

Treatment of recurrent glioblastoma multiforme (GBM) creates one of the most difficult challanges in neuro-oncology. The aim of this presentation is to evaluate the responses and survival of 24 recurrent GBM patients and toxicity in all 33 eligible patients. The study accrued patients who developed disease progression during standard treatment within eight weeks from completion of radiation therapy (RT) and six weeks from chemotherapy. Forty candidates were registered but only 33 patients were eligible. The seven noneligible patients received less than 28 days of treatment with Antineoplastons A10 and AS2-1. Among the eligible patients there were 24 cases of recurrent GBM that progressed during prior treatment, four patients with anaplastic astrocytoma and five persistent GBM. Previous treatment included surgery in all patients (18 had tumor resection, and 6 underwent biopsy only), chemotherapy in 75% of patients and radiation therapy in 88% of patients. Antineoplastons were administered intravenously every four hours (median dose of A10 10.7 g/kg/d and AS2-1 0.43 g/kg/d) until objective response was documented or until progression. The median duration of ANP treatment was 13.2 weeks ranging (4.6 – 80.3). Responses were assessed by MRI repeated every eight weeks, and or PET scan. Objective responses were determined in 16.7% of cases (complete response, and partial response in 8.3% each). Progression-free survival at six months was 25%. Overall survival is 39.3% at one year, 4.4% at two years, five and ten years. The treatment was well tolerated with reversible grades 3 and 4 toxicity including four cases of hypernatremia, two of fatigue, two of hypokalemia, and a single case of somnolence. There were no chronic toxicities. In conclusion, ANP is well tolerated and compares favorably to the current treatment for recurrent GBM.

And the next one is NO-021:

Brainstem gliomas (BSG) are rare tumors of which diffuse intrinsic pontine gliomas (DIPG) comprise a distinct group. Numerous trials have been conducted in DIPG without a proven pharmacological treatment benefit. Prior interim report on this phase II study of antineoplastons (ANP) A10 and AS2-1 provided data on 40 patients diagnosed with BSG. This report is focused on final results of 17 out of 40 patients diagnosed with recurrent pediatric DIPG (RPDIPG). The median age in this group was 8.8 years (range 4.5-18.5), with 9 females and 8 males. Previous treatment included radiation therapy (RT) in 15 patients, chemotherapy in 11 patients and surgery in 2 patients. At least eight weeks elapsed from initiation of ANP and previous RT and six weeks from chemotherapy with nitrosoureas. ANP was administered daily through a subclavian venous catheter via infusion pump. The median duration of treatment was 5.6 months. The median of average dosages of A10 was 8.8 g/kg/d and 0.40 g/kg/d of AS2-1. Responses were assessed by MRI repeated every eight weeks. In the RPDIPG group, a complete response (CR) was 6%, partial response (PR) 23.5%, and stable disease (SD) 23.5%. 6 month progression-free survival (PFS) was 35.3%. 1 year overall survival (OS) was 29.4%, 2 years 11.8%, and 5, 10 and 14 years 5.9%. One patient has OS and PFS of 14 years from the treatment start. Grade 4 toxicities including hypernatremia, hypokalemia and fatigue occurred in less than 18% of patients. Grade 3 fatigue, somnolence, skin allergy and urinary incontinence occurred in 6-12 %. There were no chronic adverse events. Responding patients experienced improved quality of life. The results suggest that ANP shows efficacy and an acceptable tolerability in patients with RPDIPG.

Once again, it’s very telling that in both abstracts, Burzynski reports there being no “chronic adverse events.” One notes that this very term is generally a bit dodgy and obviously designed to be able to avoid discussing acute adverse events, such as, again, hypernatremia. There are others, however, as I’ve discussed before, and they include high fevers (remember, Hannah Bradley documented fevers to 104° F in her video), rashes, and others. If a patient suffers life-threatening acute toxicities and no significant benefit in terms of improvement in long-term survival, then it’s likely to be a useless drug (and, make no mistake, antineoplastons are a fairly toxic drug, the claims of “natural healing” advocates notwithstanding).

Also, I can’t help but notice again that Burzynski is very canny about how he chooses which patients to present. In the first abstract, he presents only survival data from the 24 patients who completed 28 days of ANP therapy. The second abstract is even more questionable in that he references a previous preliminary report on 40 patients and then focuses this report on the final results of 17 of these patients, less than half! Why? This is a glaring omission. What happened to the other 33 patients, and why aren’t their “final” results reported? If this is the sort of work that Burzynski has been submitting to journals like The Lancet Oncology, it’s no wonder why he’s been having trouble getting published. Then he blithely mentions that grade 4 toxicities were observed in “less than” 18% of patients. Remember, grade 4 toxicities are, by definition, life-threatening toxicities that require urgent intervention. The only grade higher is grade 5, which is death itself! The next time some clueless Burzynski shill tries to claim that ANPs are “non-toxic,” I will point them to Burzynski’s own most recent abstract above, which shows that nearly one in five patients receiving ANPs suffered life-threatening toxicities. Grade 3 toxicities are, by definition, “severe but not life-threatening; hospitalization required; limitation of patient’s ability to care for him/herself,” and Burzynski reports “6 to 12%” of patients had grade 3 toxicities. Which was it? In any case, by Burzynski’s own abstract, up to 30% of patients suffer severe to life-threatening complications from ANP therapy.

As for the survival rates, neither abstract is that impressive, particularly given that an intent-to-treat analysis was clearly not done and the patients analyzed appear to have been almost cherry-picked. For instance, when M.D. Anderson reports its survival rates for recurrent DIPG, it doesn’t exclude half its patients. Moreover, we know that M.D. Anderson knows how to assess tumor response. Burzynski, on the other hand, does not, and he doesn’t even bother to keep the original images of the MRI scans, to allow verification of responses by radiologists who actually know what they’re doing.

Then, in the first abstract, there’s this statement:

The study accrued patients who developed disease progression during standard treatment within eight weeks from completion of radiation therapy (RT) and six weeks from chemotherapy.

Remember what I said about pseudoprogression? Remember how late effects of treatment can mimic tumor progression, as Liz Szabo described in her report and I discussed on at least two occasions? Remember how someone who doesn’t realize that or accept it can be fooled into thinking a tumor is progressing and then, if therapy is started during pseudoprogression, fooled into thinking whatever therapy he started to administer during pseudoprogression was responsible for shrinkage of the tumor when in fact the tumor was just doing what tumors undergoing pseudoprogression do, their area of inflammation and necrosis shrinking down after the acute insult to the tumor tissue due to the therapy. Pseudoprogression is particularly common after radiation therapy but can happen as well after chemotherapy. Burzynski couldn’t have described a study more likely to be confounded by pseudoprogression if he had tried.

It’s really depressing to think that, even now, Burzynski can slither his way into a legitimate scientific conference because at the time of the submission of abstracts few people knew how bad his science and medicine are, and even fewer knew his propensity for misreading and misassigning responses, miscategorizing and not reporting adverse events, and destroying patient records. Hopefully, Liz Szabo’s USA TODAY report took care of that problem.

In the meantime, if you’re at the Neuro-Oncology Conference, don’t forget to drop by Stan’s posters and tell him (or whoever’s manning them) that Orac said hi.

Comments

  1. #1 Eric Lund
    November 22, 2013

    There are at least two other posters in that session from Burzynski’s group:

    NO-58 A Phase II study of antineoplastons A10 and AS2-1 (ANP) in children with high-grade glioma(Protocol BT-06)
    Tomasz Janicki*1,2, Stanislaw Burzynski1,2, Gregory Burzynski1,2, Ania Marszalek1
    1Burzynski Clinic, USA, 2Burzynski Research Institute, USA

    NO-89 Long-term survival (over 13 years) in a child with recurrent diffuse pontine gliosarcoma: a case report
    Stanislaw Burzynski1,2, Tomasz Janicki1,2, Gregory Burzynski1,2, Ania Marszalek*1
    1Burzynski Clinic, USA, 2Burzynski Research Institute, USA

    The abstract numbers are apparently assigned alphabetically by first author’s name; the NO-89 abstract is in the appropriate position for Marszalek to have been the original first author, but apparently she isn’t going. So if you don’t find Stan in front of his own poster, look for the Marszalek et al. poster.

    I didn’t look at the other two abstracts, but I would assume that they are more of the same.

    Somebody on the earlier thread (I think it was lilady) had found the Janicki et al. abstract. Janicki is scheduled to present his poster, but maybe Stan or Mini-B will be covering that one, too. I found the fourth one on a hunch, since Dr. B’s team seemed to be playing the permute-the-author-list game.

  2. #2 Orac
    November 22, 2013

    D’oh! How did I miss those two? Something weird happened when I searched for Burzynski on the Neuro-Oncology website, and only the two abstracts that I discussed above popped up. I note that, of the other two abstracts you point out, one is just a case report that’s already been published. I had thought about blogging it but somehow never got around to it. The other abstract does look like more of the same. He only looks at 12 of 19 patients who met eligibility criteria. He describes the study as “two stage,” but he doesn’t explain why only 12 of 19 patients were evaluated or what the stages were. He’s also mixing tumor types. On the surface it looks like more crap.

    The other thing: I need to go back and look at whether these trial numbers are any of the trials in which Burzynski got dinged for misinterpreting scans, destroying records, and misassessing responses.

  3. #3 Ren
    November 22, 2013

    Presenting data in an abstract or poster and taking it as actual evidence is like reading the synopsis to a movie and saying that I watched it.

    I’m not saying, I’m just saying.

  4. #4 Johanna
    November 22, 2013

    I’m not a neurologist (that’s probably obvious!), but I’ve been giving serious thought to stopping by and dropping a few copies of the USA Today piece in the common areas of the hotel…

  5. #5 lilady
    November 22, 2013

    I’ve got the PubMed citation and abstract for the “NO-89 Long-term survival (over 13 years) in a child with recurrent diffuse pontine gliosarcoma: a case report”

    http://www.ncbi.nlm.nih.gov/pubmed/24136026

    J Pediatr Hematol Oncol. 2013 Oct 23. [Epub ahead of print]
    Long-term Survival (>13 Years) in a Child With Recurrent Diffuse Pontine Gliosarcoma: A Case Report.

    Burzynski SR, Janicki TJ, Burzynski GS, Marszalek A.
    Source

    Burzynski Clinic, Houston, TX.

    Johanna: I hope you are able to get to the hotel :-)

  6. #6 Fragmeister
    November 22, 2013

    Not knowing how these things work, is it the done thing to ask for data, especially the condition of the tumours when the patients first presented at the B Clinic?

  7. #7 David Westenkirchner
    November 22, 2013

    @Fragmeister You can ask anything you want that might be a question you have that is related to the poster. People submit posters to be able to stand by them to engage in discussion!

  8. #8 Chris HIckie
    November 22, 2013

    You could walk up to the poster with a copy of the USA Today article in hand and ask them about it. You could probably even walk up wearing a tshirt that says “Burzynski’s antineoplastons killed Josia Cotto”. When you do a poster, you’re pretty much stuck to stand by it for the session.

  9. #9 herr doktor bimler
    November 22, 2013

    You could walk up to the poster with a copy of the USA Today article in hand

    “Could I get your signature on this?”

  10. #10 herr doktor bimler
    November 22, 2013

    People submit posters to be able to stand by them to engage in discussion!

    That is assuming that they do actually turn up at the meeting, and have the actual poster prepared. Sometimes people submit a poster so they can point to the citation in the Conference Program as part of their CV, without having to worry about meeting peer-review standards,* and paying the charges for a conference which they have no intention of attending is simply a cost of doing business.

    * Burzynski’s publication record, in particular, leans heavily on Posters.

  11. #11 David Westenkirchner
    November 22, 2013

    “That is assuming that they do actually turn up at the meeting, and have the actual poster prepared.”

    So true @herr doktor bimler, so true!

  12. #12 AntipodeanChic
    November 22, 2013

    Sorry to state the obvious – but those Burzynski folks are just the epitome of class, aren’t they? I’d like to thank Orac for the link to Suzanne Somers’ Blog. I have to wonder now whether my liver is missing a peptide or two…

    Slightly OT for this thread, but the other day I was finally able to make myself watch “Hannah’s Anecdote”. I presume I’m not the only one who shuddered at the cavalier back-room insertion of her Hickman catheter. I’m afraid I couldn’t really discern any adequate sterile field & I have NEVER heard of these kinds of lines being inserted while the patient is only mildly sedated. I’m surprised sepsis doesn’t take out more of Dr. B’s patients than the toxicity does.

    On a lighter note, I hope @Johanna has made it down to the hotel ;)

  13. #13 Chris HIckie
    November 22, 2013

    It would be funny to have several people wearing Orac masks and SBM/RI t-shirts approach the posters as a group. Either that or have someone pretend to be interested in one of the posters and ask to get a picture next to Burzynski while someone else photobombs wearing an Orac mask.

  14. #14 sid offit
    United States
    November 22, 2013

    Yes, I’ll be there. Staying at the Monaco. Wanna meet at the Walgreens for flu shots later?

  15. #15 lilady
    November 22, 2013

    Wrong thread Bob. We’ve all gotten our flu shots.

  16. #16 T.
    November 23, 2013

    OT but… the woo claims another child:

    Mother to face criminal charges in son’s strep death
    Infection can be treated with penicillin, but mother only gave boy, 7, holistic remedies, police allege

    http://www.cbc.ca/news/canada/calgary/mother-to-face-criminal-charges-in-son-s-strep-death-1.2436945

    :(

  17. #17 Krebiozen
    November 23, 2013

    Chris Hickie,

    When you do a poster, you’re pretty much stuck to stand by it for the session.

    I have spent many happy hours standing next to a poster, usually alone, in a city far from home*, overwhelmed by the lack of interest people show in the work I have spent months putting together**.

    I would estimate that fewer than 25% of posters actually had someone in attendance. Whether the remainder didn’t turn up for the meeting, were diligently in attendance at another poster, were attending an academic lecture or were in the bar, I have no idea. My point is that my money is on a no-show by either Burzynski or his henchpeople.

    * This was mostly some years ago in the UK when attitudes to alcohol were more relaxed than today, so I was often a little worse the wear as a result of the social events the previous night. I have particularly fond memories of a soirée in Glasgow sponsored by splendidly-named Finnish company Wallac-Oy (now sadly demised) that included a free bar (ask yourself, how restrained would you be?) and as much pickled herring as you could eat. Those free fizzy vitamin C thingies given away by a certain drug company on their stands do nothing for a hangover, by the way.

    ** Not due to the poor quality of my research, of course. Even clinical biochemistry has its niches, and the number of people able to show even a polite interest in the effects of ethnic origin on prenatal screening for Down’s Syndrome, say, are limited.

  18. #18 Darwy
    Røde grøde med fløde
    November 23, 2013

    I had a poster presentation earlier this year in France.

    Yes, I stayed next to my poster throughout the session – you’d be surprised at how many folks simply walked up, pulled out their cell phone (or other camera) – took a picture of the poster – and walked off.

    All my handouts (printed copies of the poster) disappeared rapidly, as well.

  19. #19 Chris Hickie
    November 23, 2013

    @ Krebiozen, #17. I agree a lot of poster presenters just put up their poster and wander. I stayed by mine because, like you, my high-quality ™ research poster presentation just had to be on everyone’s to-visit list for that session. I needed to be standing ready in case I was offered an instant-tenured full-professor position with Howard Hughes Institute funding levels after the jaw-dropping conclusions of my poster were read (I also clearly needed a reality check back then).

    My worst/last poster experience was actually in the intern year of my residency. I’d done some database analysis of emergency room asthma treatments done using new NHLBI guidelines. I think the conclusion of my analysis was something like “It’s important that ER staff treat people with asthma exacerbations in the ER, and even better to use NHLBI guidelines for treatment”. Earth shattering stuff (as in not listed on my CV earth shattering). Anyhoo, the poster abstract was submitted in my 4th year of medical school, and accepted for the 2000 AAP NCE meeting in Chicago. It turned out I was on call (as an intern) that weekend, so I was not going to go to the meeting, and someone else from my med school was simply going to put up the poster and the invisible man would answer questions. My residency director, however, got wind that I wasn’t going to be there and essentially threatened double secret probation and other less clearly delineated punishments if I did not go and present. She commanded one of the chief residents to take my call that weekend as well (that really scores points with the chief residents, BTW). Long story short, I had no real choice but to go. I booked a flight that got me to Chicago an hour before the session. The cab got me there 10 minutes before the start. I hung the poster and the results were so stunning that no one asked any questions and I wished the invisible man had taken my place. 2 hours later I was back on a plane to Tucson wondering just what was the point.

    I hope I never do a poster again.

  20. #20 Neil J
    November 23, 2013

    In my experience, poster sessions are far and away the best part of conferences. This might have something to do with the fact that every poster session I’ve ever been to has included two free drinks (many, many more if you can snipe drink tickets from your teetotaling colleagues).

  21. #21 Eric Lund
    November 23, 2013

    As a veteran of many a poster session, I have found that they are often more useful than the standard 10-15 minute talk for conveying information. Whether a poster is better for your science than a talk depends on the conference, as well as how advanced a stage this particular research project is at. Some conferences make poster sessions a centerpiece, and even encourage attendance by providing beer, while others treat the poster session as an afterthought. It’s good to be in the former kind of poster session (I’ve never had a poster in such a session which didn’t draw some interest, even when the topic was esoteric), and bad to be in the latter. If your work is at a preliminary stage, a poster gives you more opportunities for feedback.

  22. #22 Narad
    November 23, 2013

    In my experience, poster sessions are far and away the best part of conferences.

    Try manning a booth for one of a society’s publishers. (I found that the general climate improved tremendously upon chucking the nominal pretense for the booth’s existence overboard and turning it into a buck-stops-here complaints desk that was still able to explain why the customer wasn’t always right. Or even the customer, for that matter.)

  23. #23 Krebiozen
    November 23, 2013

    Chris Hickie,

    I hope I never do a poster again.

    Me too. It’s all far more trouble than it’s worth, unless you are climbing the greasy pole of academia, which I wasn’t. It was my departmental consultant who had ordered me to go to that Glasgow meeting, despite some reluctance on my part, and my immediate line-manager was disgruntled about me being sent and not him, which meant he made my life difficult for weeks afterwards.

    Somehow my consultant managed to get a plane ticket paid for, while I had to make do with a train. I took a sleeper from Glasgow back to London, sharing a compartment with a stranger whose snoring actually drowned out the sound of the train. I got no sleep at all, as I recall. I would have been better off getting a day train and at least enjoying some scenery.

    I arrived home at 9 in the morning having been away from home for three days, most of that unpaid, sleep-deprived and exhausted, to discover my manager expected me back at work immediately. Not really my idea of fun, apart from that wild night with the free bar and smörgåsbord – I have some vague and rather embarrassing memories of hitting the dance floor with a Professor of Clinical Biochemistry – and getting the chance to wander around Glasgow.

  24. #24 Sara
    November 23, 2013

    Posters are the only way to appear on the radar at some really huge meetings and are definitely not the last tier of disseminating your work, so I completely disagree with Orac’s assertion. At the Society for Neuroscience marathon, good posters get as much attention as talks. This generalization is somewhat glib and does not apply to any of the basic science meetings I’ve been to. Maybe the clinically oriented ones, but not meetings and confabs to disseminate basic work. The people I work with would much rather babysit a poster that gets dozens of questions and interest from people strolling by than give a talk that three people will indifferently attend because they have to. You can’t generalize about posters. They have real value and elicit genuine interest depending on the venue.

  25. #25 Tartu85
    November 23, 2013

    @Sara
    Just came back from SfN, and there were a couple posters that I didn’t get a chance to look at closely because there was a crowd gathered around them at all times. At the same time, there were so so many really crappy posters with barely any data, very bad data, on them.

  26. #26 Krebiozen
    November 24, 2013

    Sara,

    You can’t generalize about posters. They have real value and elicit genuine interest depending on the venue.

    As you say, you can’t generalize: posters may have value, but equally they may have none at all. The minimal peer review involved means that a poster is of very little value as scientific evidence. That was the point Orac was making, I think.

  27. #27 Sara
    November 24, 2013

    Yes, it’s a popularity contest. “Sexy” topics (hate that almost as much as “elegant”!) are just captivating ads in a medium that has no editorial filter. I should have said that they CAN have real value that’s overlooked; but without peer review they can be no more than tantalizing hints of something else. Didn’t say that well.

  28. #28 David W
    November 25, 2013

    So, did anyone actually attend the conference and see the Burzynski posters??

  29. #29 Eric Lund
    November 25, 2013

    You can’t generalize about posters. They have real value and elicit genuine interest depending on the venue.

    Certainly posters can have value, both for the presenter and for the audience. But the kook filtering is between minimal and nonexistent. At least one major scientific society, the American Physical Society, is known for organizing crackpot sessions at their meetings for entertainment purposes (rumor has it that chairing the crackpot session is one of the duties of the president of APS). My primary scientific society, the American Geophysical Union, requires people submitting abstracts to their annual meeting to be members (or sponsored by a member), and restricts the number of abstracts on which you can be first author, but otherwise accepts any abstract that fits their topical purview, and anyone can join AGU. So there is no guarantee that a poster has any valid scientific content. It’s useful for presenting preliminary work, and making yourself visible in the field, but you have to understand the limitations.

  30. #30 palindrom
    November 25, 2013

    Eric – Speaking of posters, have fun at AGU, where I expect you’re going shortly along with many folks we know in common.

    Say hi to all the global warming types — just let ‘em know that a whole bunch of people are onto the giant hoax they’re all perpetrating. (/heavy sarcasm.)

  31. #32 eNOS
    holed up in the lab for Thanksgiving
    November 25, 2013

    OT..sort of, but I was feeling particularly self-flagellating this afternoon so I clicked the DJT linkout (or whatever its called) at #31.

    Wow.

    Either I can’t find whatever point it’s making, or that’s just timecube-level crazy.

    Carry on.

  32. #33 Lawrence
    November 25, 2013

    @eNOS – I don’t believe there is a rational bone in that guy’s body…he posts up a link here, just to try to drive “curiosity-seekers” to his blog…..incoherent doesn’t even begin to describe him.

  33. #34 palindrom
    November 25, 2013

    Lawrence @33 — Crank.net uses the wonderful category “illucid” for some of its crankier entries. This adjective is all too useful these days.

  34. #35 Lawrence
    November 25, 2013

    @Palindrom – yes, a very good term….hey, at least I got an honorable mention over at insano’s site…kind of funny, actually.

  35. #36 eNOS
    November 25, 2013

    I was unaware of the existence of crank.net. This is just wonderful and along the lines of tvtropes for a good afternoon of time wasting or entertainment between western blot transfers. Thank you!

  36. #37 Eric Lund
    November 25, 2013

    eNOS@32: I infer from the domain name that this dude is pro-Burzynski (or at least thinks he is), but have never followed his trackback links to find out. (Presumably Rajmund is Dr. B’s middle name–that would be the Polish equivalent of Raymond.) He went for alliteration in this post title, but I have no idea what “stupendous stupendity” (sic, from our Department of Redundancy Department) is supposed to mean. I’ll take your word for it that the post would not enlighten me on this point.

  37. #38 Dave Gillespie
    United States
    November 25, 2013

    I have the poster hand-outs for the 2 A10/AS2-1 posters. I did not attend it but my colleague did and picked them up for me. Where should I send the scans?

  38. #39 Krebiozen
    November 25, 2013

    DJT stomped about the scepticsphere for several months, including a sojourn here, insulting anyone who criticized Burzynski. He had multiple accounts banned on Twitter and has mostly retreated back to the almost comment-free blog he created. He did apparently debate Bob Blaskiewicz about Burzynski somewhere, but I haven’t expended much energy finding the transcript, as DJT is just too far gone for it to be interesting. I’m a bit concerned for his mental health, sincerely.

    Does anyone have any idea what the photo at the top of his blog represents? It looks like a gloved hand wiping away a drop of urine, but I could be mistaken.

  39. #40 Narad
    November 25, 2013

    Does anyone have any idea what the photo at the top of his blog represents? It looks like a gloved hand wiping away a drop of urine, but I could be mistaken.

    It appears to be a cropped image of Gumby. Don’t ask me.

  40. #41 eNOS
    November 26, 2013

    @Eric
    There isn’t much of a post to speak of, as it goes. It’s mostly a smattering of links to other blog posts, miscellaneous things in brackets and bolded , and my god would you look at the tags. Those alone had to take up half the afternoon.

    The exchange with Bob would be entertaining, although I don’t know if I could parse DJT’s comments, given his “interesting” online vernacular.

    The photo on top is indeed gumby, turned on his side it looks like. The full picture appears as the thumbnail on a tab if you have the blog opened in firefox (probably chrome as well).

  41. #42 Orac
    November 26, 2013

    DJT amuses me. It’s the only reason I let his Trackbacks through.

  42. #43 Lawrence
    November 26, 2013

    @Orac – I glance at his page from time to time…still incoherent….though getting a mention from him (well, pissing him off, actually) did give me quite the thrill….lol

  43. #44 Narad
    November 26, 2013

    The photo on top is indeed gumby, turned on his side it looks like.

    When I was looking at this last night, it seemed as though, based on where the drops of moisture appear on the thunbnail (which does not appear anywhere when I view the page in Firefox), it was probably Gumby’s right hand, cropped with the image upside-down. Then again, I’m little inclined to check again.

    I’m mildly amused by all the dot-anchored links at the top that are password-protected. Because, you know, if I want to organize files, I always put the cabinet out on the sidewalk with a sign on it saying “IMPROTNT FLIES” and then safeguard the key.

  44. #45 Krebiozen
    November 26, 2013

    Does anyone have any idea who DJT is? I don’t mean a name, I don’t want to out him, but I wonder whether he is associated with Burzynski in any way, if he has had a relative ‘cured’ by Burzynski, or if is he is just a concerned citizen, as it were.

    Whoever he is, he seems to have put a gargantuan effort into producing an enormous amount of evidence that he has a somewhat tenuous grip on reality. Gumby indeed. Truly bizarre.

  45. #46 AdamG
    November 26, 2013

    Does anyone have any idea who DJT is?

    Orac knows…I’m pretty sure I remember him saying he had a pretty good idea, at least.

  46. #47 AntipodeanChic
    Apparently, the Land of "Asinine & Stupendous Stupidity (Pop. 1)"
    November 26, 2013

    Oh dear! There I was, on tenterhooks overnight, fearing that I may have brought Respectful Insolence into some kind of dreadful disrepute.*

    Granted, I had tried to make a weak joke about Suzanne Somers’ handing out medical advice – but I cannot fathom why pointing out an instance of dodgy clinical protocol should earn one an entire blog post, particularly as nobody else on the thread even responded to it. Clearly, my stupidity & lack of experience in that particular field must be to blame.**

    Now, I had intended to avoid providing more fodder for my new friend but I agree with Krebiozen – I have to wonder at his motivation(s)?

    *Sarcasm
    **Searing sarcasm tinged w/ bemusement

  47. #48 eNOS
    November 27, 2013

    This may come through twice, as the first was given a “you’re posting comments to quickly” error.

    I didn’t even realize those dots on the top were links. Odd.
    I do wonder what he thinks he’s accomplishing with his rhetoric. The only thing I can really make out is that he is a Burzynski supporter, as Kreb mentioned above, but surely he can’t believe anyone on the same side considers him a legitimate ally when he posts all that mess. I will note that the about section is a bit more readable. I wonder if all this talk will open the gates for him here. Are he and his various iterations banned? I forget.

    Oh, and Narad, this is the tiny Gumby thumbnail I referenced that appears in Firefox: http://imgur.com/XG3vSKA

  48. […] Burzynski himself tried to answer the FDA findings and failed miserably, nor did his poster presentation of singularly unimpressive results at the Society of Neuro-Oncology Meeting right before Thanksgiving help. The year ended with the […]

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