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HEALTH SERVICES RESEARCH AND QUALITY OF CARE Let the Sunshine In: Industry’s Impact on Oncology Research and Practice CHAIR Beverly Moy, MD, MPH Massachusetts General Hospital Cancer Center Boston, MA SPEAKERS Richard B. Gaynor, MD Eli Lilly and Company Indianapolis, IN Reshma Jagsi, MD, DPhil University of Michigan Ann Arbor, MI Mark J. Ratain, MD The University of Chicago Chicago, IL
MOY ET AL The Impact of Industry on Oncology Research and Practice Beverly Moy, MD, MPH, Reshma Jagsi, MD, DPhil, Richard B. Gaynor, MD, and Mark J. Ratain, MD OVERVIEW Public scrutiny has increased over potential conflicts of interest among oncology researchers and providers. Given the increased prevalence and complexity of industry relationships, oncologists are increasingly faced with ethical challenges when navigating their financial relationships with industry. Oncologists are continually dealing with changing conflict of interest policies within academic centers and professional societies. With the recent passage of The Sunshine Act, oncologists are beginning to understand the repercussions of this new law. The consequences of the increasing use of direct-to-consumer advertising on patients with cancer are also unclear. Finally, industry’s perspective on the evolution of these relationships is not clearly understood. This manuscript discusses issues related to industry’s influence on oncology practice and research. Financial relationships between industry and oncology physicians and researchers are common. These relationships consist of research support, consultative fees, honoraria, and gifts. Recently, public scrutiny has increased about potential conflicts of interest that could arise in the oncology community. Given the increased prevalence and complexity of industry relationships, oncologists are increasingly faced with ethical challenges when navigating their fınancial relationships with industry. Recent attention has been focused on physician–industry relationships in the wake of the Sunshine Act. Oncology researchers are forced to keep up with continual revisions of conflict of interest policies within academic centers and professional societies. The effect of the rise in direct-toconsumer advertising (DTC) on patients with cancer is also unclear. DTC advertising results in multiple ethical challenges since physicians are unable to function as unbiased intermediaries between patients and industry. Industry’s effect on physicians and patients with cancer is multidimensional and becoming increasingly complex. Patient and public reaction to these developments necessitate education and clarifıcation of these complex issues. We will explore some of the issues relating to the effect of industry on oncology research and practice in the modern era. FINANCIAL CONFLICTS OF INTEREST Financial relationships between the pharmaceutical industry and oncology are common and increasing over time. 1-3 A cross-sectional survey of cancer clinical trials and editorials conducted in 2005 revealed that 44% of clinical trials were entirely or partially funded by industry. 4 Another study reported that 23% of all abstracts and 60% of plenary session abstracts from 2004 to 2005 at the American Society of Clinical Oncology (ASCO) Annual Meeting reported at least one author with an fınancial conflict of interest (FCOI). 2 A more recent analysis of ASCO Annual Meeting abstracts from 2006 to 2011 reported that 36% of all abstracts had at least one FCOI and that abstracts with FCOIs were featured at more prominent sessions at the Meeting. 5 These data demonstrate the increased influence of industry in oncology research and practice. In the past, arguably the most prominent cancer research was funded by the federal government in the form of cooperative group studies. However, in recent years, there has been a shift toward industry-funded trials leading to the development and approval of cancer therapeutics. Modern cancer research has increasingly relied on effıcient conduct of clinical trials using the newest anticancer therapeutic agents. Therefore, cancer researchers have formed increasing ties to industry given their access to research infrastructures and novel therapeutic agents. The increasing relationship between industry and oncologists leads to both positive and negative consequences. 6,7 On the positive side, close collaboration between biomedical researchers and industry has undeniably facilitated the development of many new medical therapies. 8 Developmental therapeutics is an area in which key interests of the oncology researcher, patient, and industry are aligned. The patient community seeks effective new therapies, biomedical researchers and oncologists wish to translate basic discoveries into treatments, and industry wishes to develop new products. 9 However, as oncology researchers work more closely with industry, questions arise whether fınancial compensa- From the Massachusetts General Hospital Cancer Center, Boston, MA; University of Michigan, Ann Arbor, MI; Eli Lilly and Company, Indianapolis, IN; The University of Chicago, Chicago, IL. Disclosures of potential conflicts of interest are found at the end of this article. Corresponding author: Beverly Moy, MD, MPH, Center for Breast Cancer, Massachusetts General Hospital, 55 Fruit St., Yawkey 9A, Boston, MA 02114; email: bmoy@mgh.harvard.edu. © 2015 by American Society of Clinical Oncology. 130 2015 ASCO EDUCATIONAL BOOK | asco.org/edbook
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AMERICAN SOCIETY OF CLINICAL ONCOLO
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American Society of Clinical Oncolo
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Controversies in Neoadjuvant Therap
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Clinical Trials of Precision Medici
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Managing Ovarian Cancer in the Olde
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Updates in the Multimodality Manage
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PEDIATRIC ONCOLOGY Real-Time Molecu
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2015 ASCO Annual Meeting Disclosure
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2015 Educational Book Expert Panel
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James Marshall, PhD Roswell Park Ca
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2015 Annual Meeting Supporters* MIS
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David Yurman Corporate Allies Conqu
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INVITED ARTICLES This year’s invi
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BREAST CANCER Individualizing the A
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REFORMING THE BUY-AND-BILL CHEMOTHE
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ZARDAVAS AND PICCART-GEBHART TABLE
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MICHAEL A. POSTOW Managing Immune C
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GASTROINTESTINAL (NONCOLORECTAL) CA
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ABOU-ALFA ET AL sess liver function
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ABOU-ALFA ET AL mors including HCC,
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ABOU-ALFA ET AL HCC (Anti-Programme
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AHN ET AL Making Sense of Current a
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AHN ET AL Pancreatic cancer has bee
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AHN ET AL Disclosures of Potential
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EGIDIO DEL FABBRO tion of precachex
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EGIDIO DEL FABBRO FIGURE 3. Mechani
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EGIDIO DEL FABBRO II RCT of ghrelin
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EGIDIO DEL FABBRO 22. Tan BH, Birds
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THE SPECTRUM OF NEUROENDOCRINE TUMO
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CHALLENGING THE TREATMENT PARADIGM
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STAGE I TESTICULAR GERM CELL CANCER
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STAGE I TESTICULAR GERM CELL CANCER
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GERM CELL TUMORS: LOOKING TO THE FU
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SALVAGE CHEMOTHERAPY Salvage Therap
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EARLY CHEMOTHERAPY IN MEN WITH META
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IMMUNOTHERAPY FOR PROSTATE TUMORS I
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NOVEL IMMUNOTHERAPY AGENTS IN METAS
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PROMISING STRATEGIES IN BLADDER CAN
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GYNECOLOGIC CANCER Cervical Cancer
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HEMATOPOIETIC CELL TRANSPLANTATION
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HEMATOPOIETIC CELL TRANSPLANTATION
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LEUKEMIA, MYELODYSPLASIA, AND TRANS
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MICHAEL W. DEININGER TABLE 1. Defin
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MICHAEL W. DEININGER the ATP-bindin
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MICHAEL W. DEININGER broad range ef
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MICHAEL W. DEININGER 30. Hughes T,
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PEMMARAJU AND MOLITERNO TABLE 1. Ac
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PEMMARAJU AND MOLITERNO drome (BCS)
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PEMMARAJU AND MOLITERNO 13. Xing S,
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THERAPIES AND INDICATIONS FOR PH-NE
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LEUKEMIA, MYELODYSPLASIA, AND TRANS
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LUNG CANCER Beyond Second-Line Trea
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BEYOND SECOND-LINE TREATMENT FOR LU
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BEYOND SECOND-LINE TREATMENT FOR LU
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LUNG CANCER New Therapies for Histo
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GERBER, PAIK, AND DOWLATI a tumor t
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GERBER, PAIK, AND DOWLATI squamous
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GERBER, PAIK, AND DOWLATI FIGURE 2.
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GERBER, PAIK, AND DOWLATI gression
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GERBER, PAIK, AND DOWLATI Disclosur
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GERBER, PAIK, AND DOWLATI enzyme in
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GERBER, PAIK, AND DOWLATI receptor
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LILENBAUM, LEIGHL, AND NEUBAUER Exp
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BERNARDO H.L. GOULART The Value of
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BERNARDO H.L. GOULART every 6 month
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BERNARDO H.L. GOULART lung-cancer/l
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LUNG CANCER Updates in the Multimod
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WOODARD AND JABLONS section, becaus
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NASSER HANNA Current Standards and
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NASSER HANNA At the 2014 ASCO Annua
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NASSER HANNA culty of this task. Va
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LYMPHOMA AND PLASMA CELL DISORDERS
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NOWAKOWSKI AND CZUCZMAN sociated wi
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NOWAKOWSKI AND CZUCZMAN 15. Aragon-
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DAVID W. SCOTT Cell-of-Origin in Di
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DAVID W. SCOTT FIGURE 1. The Origin
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DAVID W. SCOTT FIGURE 2. Immunohist
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DAVID W. SCOTT FIGURE 3. The Lymph2
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CHEAH, OKI, AND FANALE Novel Treatm
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CHEAH, OKI, AND FANALE TABLE 3. Sel
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STEPHEN ANSELL associated with pati
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STEPHEN ANSELL Disclosures of Poten
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MATEOS AND SAN MIGUEL Smoldering Mu
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MOREAU AND TOUZEAU Multiple Myeloma
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LYMPHOMA AND PLASMA CELL DISORDERS
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MANAGEMENT OF CLL Up-Front Manageme
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MANAGEMENT OF CLL than 17p-/TP53mut
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MANAGEMENT OF CLL could be associat
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MANAGEMENT OF CLL tion by nonmalign
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MANAGEMENT OF CLL lymphocytic leuke
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PROGNOSTIC FACTORS AND ADJUVANT RAD
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MERKEL CELL CARCINOMA Merkel Cell C
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MERKEL CELL CARCINOMA tions in PIK3
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MERKEL CELL CARCINOMA 32. Leonard J
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MELANOMA/SKIN CANCERS Locoregional
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PERFUSION AND INFUSION IN THE ERA O
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NEOADJUVANT THERAPY OF MELANOMA Neo
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NEOADJUVANT THERAPY OF MELANOMA ity
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MELANOMA/SKIN CANCERS Targeted Mole
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SULLIVAN ET AL FIGURE 1. Relevant S
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SULLIVAN ET AL Resistance to BRAF i
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SULLIVAN ET AL 17. Halait H, Demart
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SULLIVAN ET AL NRAS-mutant melanoma
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KLEPIN, RODIN, AND HURRIA Treating
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KLEPIN, RODIN, AND HURRIA plication
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PERIPHERAL NEUROTOXICITY IN CANCER
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PARTRIDGE, JACOBSEN, AND ANDERSEN C
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PARTRIDGE, JACOBSEN, AND ANDERSEN c
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PARTRIDGE, JACOBSEN, AND ANDERSEN w
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PARTRIDGE, JACOBSEN, AND ANDERSEN v
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LESLIE R. SCHOVER Sexual Healing in
Page 782 and 783:
LESLIE R. SCHOVER tinuous ADT in pr
Page 784 and 785:
LESLIE R. SCHOVER 12. Potosky AL, H
Page 786 and 787:
CATHERINE H. VAN POZNAK TABLE 1. Wo
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CATHERINE H. VAN POZNAK (tamoxifen,
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CATHERINE H. VAN POZNAK TABLE 3. FD
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CATHERINE H. VAN POZNAK premenopaus
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SHARI GOLDFARB KEY POINTS Brea
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SHARI GOLDFARB and friction with va
Page 798 and 799:
SHARI GOLDFARB importance both duri
Page 800 and 801:
PATIENT AND SURVIVOR CARE Moving Su
Page 802 and 803:
MAYER ET AL TABLE 1. Quality Metric
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MAYER ET AL to enhance the quality
Page 806 and 807:
MAYER ET AL FIGURE 2. (A) Infertili
Page 808 and 809:
MAYER ET AL efıcial suggests that
Page 810 and 811:
PATIENT AND SURVIVOR CARE The Chall
Page 812 and 813:
BRUERA AND PAICE Choice of Opioid a
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BRUERA AND PAICE toxicity and proce
Page 816 and 817:
BRUERA AND PAICE effective. Basic s
Page 818 and 819:
PEDIATRIC ONCOLOGY Real-Time Molecu
Page 820 and 821:
CARROLL, RAETZ, AND MEYER KEY POINT
Page 822 and 823:
CARROLL, RAETZ, AND MEYER most are
Page 824 and 825:
CARROLL, RAETZ, AND MEYER markers a
Page 826 and 827:
PEDIATRIC ONCOLOGY Translating Surv
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REDUCING THE BURDEN OF LATE EFFECTS
Page 830 and 831:
Page 832 and 833:
Page 834 and 835:
Page 836 and 837:
PROFESSIONAL DEVELOPMENT The Challe
Page 838 and 839:
ADVANCES IN WEBSITE INFORMATION RES
Page 840 and 841:
Page 842 and 843:
Page 844 and 845:
Page 846 and 847:
COMMUNICATION AND TECHNOLOGY: IT’
Page 848 and 849:
Page 850 and 851:
Page 852 and 853:
PATIENT-REPORTED OUTCOMES IN ONCOLO
Page 854 and 855:
PATIENT-REPORTED OUTCOMES IN ONCOLO
Page 856 and 857:
PROFESSIONAL DEVELOPMENT Trends, An
Page 858 and 859:
CLINICAL ONCOLOGY PRACTICE 2015 FIG
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CLINICAL ONCOLOGY PRACTICE 2015 (6.
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CLINICAL ONCOLOGY PRACTICE 2015 Pro
Page 864 and 865:
ADJUVANT/NEOADJUVANT MEDICAL THERAP
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Page 868 and 869:
Page 870 and 871:
INDICATIONS FOR ADJUVANT RADIATION
Page 872 and 873:
Page 874 and 875:
Page 876 and 877:
Page 878 and 879:
SARCOMA Latest Advances in Systemic
Page 880 and 881:
SYSTEMIC THERAPY FOR OSTEOSARCOMA A
Page 882 and 883:
SYSTEMIC THERAPY FOR OSTEOSARCOMA A
Page 884 and 885:
RETHINKING TREATMENT FOR CHONDROSAR
Page 886 and 887:
Page 888 and 889:
Page 890 and 891:
Page 892 and 893:
BONE SARCOMAS IN ADULTS local disea
Page 894 and 895:
BONE SARCOMAS IN ADULTS structure a
Page 896 and 897:
SARCOMA Well-Differentiated and Ded
Page 898 and 899:
ABBAS MANJI ET AL ticular region. 7
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ABBAS MANJI ET AL MYXOID (ROUND CEL
Page 902 and 903:
ABBAS MANJI ET AL versus doxorubici
Page 904 and 905:
SHLUSH AND HERSHKOVITZ Clonal Evolu
Page 906 and 907:
SHLUSH AND HERSHKOVITZ FIGURE 1. Ti
Page 908 and 909:
TUMOR BIOLOGY New Strategies to Und
Page 910 and 911:
KNAPP, DHAWAN, AND OSTRANDER in dog
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KNAPP, DHAWAN, AND OSTRANDER TABLE
Page 914 and 915:
KNAPP, DHAWAN, AND OSTRANDER 14. Fe
Page 916 and 917:
SOURBIER, SRINIVASAN, AND LINEHAN M
Page 918 and 919:
SOURBIER, SRINIVASAN, AND LINEHAN F
Page 920 and 921:
SOURBIER, SRINIVASAN, AND LINEHAN T
Page 922:
Author Index Abbas Manji, Gulam ...
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