Disclosure, finances, and the oncologist

Conflict-of-interest rules lacking enforcement

According to the BMJ, oncologists in the US have a problem with disclosure. Research in the journal JAMA Oncology has revealed a significant number of US oncologists are failing to disclose payments from trial sponsors. Researchers now know that a number of FDA-approved medicines that successfully passed trials have involved oncologists profiting from drug company sponsorships – without declaring their complete financial interests.

José Baselga: lying by omission

The head medical officer at New York’s Memorial Sloan Kettering Cancer Centre has a history of working in the development of numerous cancer therapies – sitting on the board of at least six companies in the past five years. Baselga has also held the editor-in-chief position in the Cancer Discovery Journal.

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During his tenure, he failed to include evidence that he was receiving payments from cancer research companies – thus breaking the code of the journal he was supposed to be editing. He is also reported to have delivered speeches at conferences without divulging his vested interest in companies and products he was recommending.

He has defended himself by stating that he has worked in the public eye and that he understands the importance of disclosure.

Read the report by ProPublica here.

A new scandal in oncology – an old issue

Baselga’s indiscretion illustrates the ease with which even prominent doctors can mask financial gain in clinical trials. In 2009, a slew of reports emerged – including a prominent piece by PLOS – which discussed this very issue. Perhaps this latest story is evidence that little has improved. The light penalties for non-disclosure of financial interests – and the fact that very few doctors have ever been disciplined – do little to effect any significant change.

The chief executive of Memorial Sloan also independently settled multiple disclosure lawsuits since 2010.

Disclosure versus disclosure

Research into oncology cannot function without input, support, and financial backing from pharmaceutical companies. However, a collaborative approach does not necessitate secrecy with regards to doctors’ income. Since 2013, drug manufacturers in the US have been legally required to disclose their payments to doctors, but those not approved by the FDA are not.

Baselga has reported his income (or parts of it) in many different places but has never disclosed a single document laying everything out clearly.

It is estimated that more often than not, Baselga (and probably others) has failed to declare any conflict of interest in trials, reports, or articles. However, a number of these publications dealt with early R&D phase pharmaceuticals still in their conceptual phase, and therefore not required to be accounted for.

Oncology and trust: moving forward

Despite having omitted his relationship to numerous drug companies in articles published in The Lancet and other prestigious journals, Baselga maintains that he has made discretionary errors only. He has called his mistakes “inconsistencies” and continues to stress his understanding of their importance. Rather than mounting a witch-hunt against a lone oncologist, perhaps the American Association for Cancer Research (and the press) can utilize these findings as a catalyst for change in a system far too permeable to remain compliant.

Interested in oncology? Why not read our recent piece on cancer screening?