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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