So, the Burzynski clinic has finally issued an offical response to the ongoing shenanigans with Rhys Morgan and Andy Lewis; a press release in which it disassociates itself from the action of Marc Stephens before making further noises about the possibility of legal action:

Marc Stephens was recently hired by the Burzynski Clinic as an independent contractor to provide web optimization services and to attempt to stop the dissemination of false and inaccurate information concerning Dr. Burzynski and the Clinic.

We understand that Marc Stephens sent a google map picture of a blogger’s house to the blogger and made personal comments to bloggers. Dr. Burzynski and the Clinic feel that such actions were not appropriate. Dr. Burzynski and the Burzynski Clinic apologize for these comments. Marc Stephens no longer has a professional relationship with the Burzynski Clinic.

These bloggers will be contacted by attorneys representing the Clinic informing them of the specific factual statements contained in these blogs which the Clinic believes are false and defamatory, including the following:

I find the admission that the clinic hired Stephens specifically to ‘attempt to stop the dissemination of false and inaccurate information concerning Dr. Burzynski and the Clinic’ particular interesting as this suggests that Stephens was, in effect, operating as a paid astroturfer.

Moving on, the press release identifies three specific statements which the clinic appears to believe to be false and defamatory, which it lists as follows:

A.  Antineoplastons are made from urine. False – Antineoplastons are synthesized from chemicals.

That’s an argument that might well bamboozle a few alt-med junkies, but not skeptics, particularly when David Colquhoun has already covered some of the basics:

The Burzynski treatment is piss. Literally. A mixture of substances extracted from the patient’s own urine is dubbed with the preoposterous pseudoscientific name “antineoplastons”. There are no such things as “neoplastons”,
The main component seems to be a simple organic chemical, phenylacetic acid (PA). It is produced in normal metabolism but the liver copes with it by converting it to phenylacetyl glutamine (PAG), which is excreted in the urine.>

This nevertheless raises some interesting additional questions which arise out of some the information given in the Texas Medical Board’s current complaint against Burzynski, which notes that both patients whose cases are cited in the complaint were prescribed an off label orphan drug, sodium phenylbutyrate which, when taken orally, is metabolised in the liver into a combination of phenylacetylglutamine and phenylacetate, these being the prime components of Burzynski’s ‘antineoplaston’ AS2-1.

This piqued my interest sufficiently to warrant a couple of searchs on PubMed and ClinicalTrials.gov, just to see what cancer researchers are/have been getting up to with sodium phenylbutyrate, and although there’s been some interest in drug there seems to very little concrete evidence, to date, other than some lab bench studies and a few phase 1 trials looking at tolerability and side effects at different dosages. The trial listed at clinicaltrials.gov do contain a small number of completed phase II trials, but none of these have added any data to their entries and I’ve yet to find any published, peer reviewed, papers relating to any of the cancer-related trials, some of which were completed 6-8 ago.

This seeming lack of publications from any phase 2 trials is a bit of red flag as it rather suggests that any results were highly likely to have been either inconclusive or negative and, if the information in the TMB’s complaint is correct, it would appear that Burzynski has prescribed these particular meds to patients on the back of some extremely limited data from phase 1 trials, none of which relate specifically to the cancers for which the drug was given.

There is also no record of Burzynski ever registering a trial using sodium phenylbutyrate or, indeed, any of the other med cited in the complaint.

Despite the apparent interest in sodium phenylbutyrate from other researchers, the only obvious purpose it appears to have served in either of the cases cited in the TMB complaint appears to have been that of stimulating the production of chemicals used in the production of Burzynski’s ‘antineoplaston treatment’, some of which the patient would then have presumably excreted via the urinary tract…

…while taking a piss.

Moving on, we come to…

B.  That Dr. Burzynski falsely claims to have a PhD.- False In fact, Dr. Burzynski has a Ph.D. from the Medical Academy of Lublin and a copy of an official affidavit will be put up on the Burzynski Clinic web site (www.cancermed.com).

Burzunski’s summary records at the Polish science registry show that he completed his medical studies in 1967 (no exact date), in addition to listing a doctoral dissertation with a date of 01/01/1968 but no title. The specific record for the dissertation does state that it was a PhD thesis however, on his main entry, the resulting degree is listed as ‘Doctor of Medicine’.

This is all rather ambiguous, not least because Burzynki’s own CV lists his credential as:

M.D with distinction 1967

PhD (biochemistry) 1968

All of which implies that he completed a PhD in only a year, and after gaining his M.D. when the date given for his dissertation – 1 Jan 1968 – looks rather like a purely administrative date, i.e. a standard award date for studies completed during the previous year, regardless of the actual date of the thesis.

So while it does appear that Burzynski did produce a PhD thesis during, and seemingly as part of, his M.D. studies, its not entirely clear whether that entitles him to lay claim to a PhD in addition to his M.D. in terms of how these credentials are generally understood in the US.

C.  There are no scientific studies supporting antineoplaston treatment since 2006. False – below is a list of publications and abstracts providing the results of the FDA approved clinical trials since 2006 which demonstrate the treatment’s efficacy on a wide variety of brain tumors.

Running down Burzynski’s new list of 13 additional citations was going to be my main task for today but, happily, Jen McCreight beat me to it and managed to both save me a job and give me a welcome excuse to send a bit of linky-love to a first rate female skeptic blogger.

Truth be told, there’s not much I can add to Jen’s rundown of Burzynski’s ‘studies’. Two of the citations lead to journals with a zero impact factor, one of which is an open access journal for which Jen offers this assessment:

I couldn’t find out anything about the editorial board other than there’s some guy in Greece you should submit things to. And after a lot of digging, I couldn’t find an impact factor at all.

A third citation leads to a journal called ‘Integrative Cancer Therapies’ – so that’s an alt-med journal for starters – and the paper it relates to hasn’t been published since 2006, it was actually published in 2006 and is currently the last but one of Burzynski’s entries on PubMed.

Actually, one of the two zero impact journal papers, which was published in ‘Pediatric Drugs’, also dates to 2006 and appears as his last entry on PubMed, so at least part of Burzynski’s claim that scientific studies which support his work have been published since 2006 is based on papers publish in 2006, which is all just a little disingenuous if you ask me.

As for the rest of his ‘output’ since 2006, these are all conference abstracts, including the only paper on which Burzynski does not appear as an author, at least three of which (all 2009) were nothing more than poster presentations, at which Burzynski would have stood in front of poster showing his results, in what is the equivalent of a tradeshow hall, for maybe a couple hours, answering questions about his research, if any of the other delegates could actually be arsed to go up to him in the first place.

Presentations of this kind may be peer reviewed, or they may not – it all depends on the conference – but not by the journal in which the abstract appears, and if presentations are peer reviewed then they will tend not to be given anything like the same degree of scrutiny as papers submitted for publication. At some conferences, for example, submissions may be sored by a reviewer with the best scoring presentations being given a 10-15 minute presentation slot, with the rest being consigned to the tradeshow hall.

Conference presentations can be a very good way of gaining attention for your research, but they can also be readily misused to quickly rack up a stream of largely meaningless citations in relatively prestigious journals without any of the work being subjected to the full pre-publication peer review process, creating artificially inflated citation counts for work which may have little or no actually scientific merit.

So, on the whole, Burzynki’s complaints seem rather on the thin side, should he actually go ahead with his threat to set his attorneys on ‘UK bloggers’.

The irony in all this, of course, is that Burzynski and his supporters have spent months – and a decent amount of money – mounting their own conspiracy-laden propaganda campaign, as a direct response to the Texas Medical Board’s latest attempt to revoke his medical licence, only to see their efforts disappearing rapidly down the crapper as a direct result of their own hired astroturfer’s decision to pick a fight with a couple of very well respected skeptic bloggers.