Conflicts And Cancer Centers

By

Leonard Zwelling

The spotlight has been on Memorial Sloan Kettering Cancer Center and the fall of its chief medical officer Jose Baselga, but my bet is that this could have been any major cancer center and another executive or professor on the faculty. There simply is insufficient discipline over the holdings of members of the faculty and members of the boards of these centers with regard to companies making products developed and/or being tested at these institutions.

Why is that a problem in the age of the Bayh-Dole Amendment which allows the commercialization of discoveries made at academic institutions using federal grant money?

It’s simple.

The major mission of an academic institution such as a cancer center is the generation of knowledge that will help mankind. For this privilege, the centers have tax-exempt status, despite the fact that most generate a “margin.”

In the case of cancer centers, the mission is to advance the fight in the prevention, detection and treatment of malignant disease. The major vehicle by which cancer centers advance that mission is called research. This is the pursuit of truth in the areas of the prevention, detection and treatment of cancer. It includes basic, clinical and population-based science and even the most basic of discoveries may be of great clinical significance. A Nobel Prize was just awarded to an MD Anderson faculty member who made basic discoveries that led to the development of new ways to treat cancer. The stock value rises on the report of the basic science finding, not only when its clinical efficacy is proven. That science is basic does not mean the scientist cannot cash in on his own research results.

The idea here is that academics should do what they do, not to make money, but to advance science. Now there is nothing wrong with these scientists making money from their discoveries and centers, such as MD Anderson, have policies that allow the faculty to share in the financial benefits of their work. BUT—and this is a big but—the first fiduciary duty of the faculty is to the truth. If the results of the research done by the faculty will directly benefit the faculty member financially, that’s a conflict of interest and ought to be banned. So should any payments from a drug company to a faculty member doing work for the drug company beyond defraying the cost of the research. Faculty members should not be hawking products for privately-held or publically-held companies. Their professional opinion should not be for sale especially if they are “opinion leaders” whose ideas can not only alter the course of science but also the course of the Dow.

There needs to be a strict separation between the work for which any faculty member is paid by his or her institution and the revenue stream to that faculty member from the private sector. Period. You can’t do research that would alter the value of your stock portfolio. Period. You cannot take money for speaking for a drug company about the research you did sponsored by that drug company. Why should anyone believe your research if your results inflate your ability to make boat payments?

The firewall should be high, deep and wide. I was stunned to learn that Craig Thompson who is President of MSKCC, makes $6.7 million (NY Times, October 2) and still wants more from his seats on corporate boards whose products his institution buys. How greedy can you get!

I think that the salaries paid these executives are outrageous and that includes the ones reported for Dr. DePinho and his immediate underlings. The president of MD Anderson should not make more than the president of UT Austin. I get why the football coach makes all that money, even though its lewd, but for goodness sakes how much is enough? In New York City, there clearly is no upper limit regardless of where the money comes from.

Memorial will have to deal with the fallout from the greed of its leaders. Frankly, I think they all should have known better and ought to leave. I thought the same of past leaders of MD Anderson as well.

Is there any wonder why the faculty of Sloan Kettering is in an uproar over this and that the faculty of MD Anderson ought to be examining this as well. There is no managing this greed. It just has to go. It will be up to the faculty to make sure MD Anderson does not suffer the same PR repercussions that Sloan Kettering has because I am not sure the upper reaches of UT has figured this out yet.

Leonard Zwelling