The Outrage Of The Second Slide

By

Leonard Zwelling

As a previous blog has noted, I took the time to hear a few of the presentations at the CTOS meeting in Japan in mid-November. Along with the success that some are having in treating aggressive sarcomas, the frustration of facing the limited additional progress that has been made in the past ten years, and the persistence of the large cooperative groups doing pedestrian chemotherapy trials unlikely to show anything more than incremental progress, there is the fact that the large pharmaceutical companies have never supported the pediatricians and internists treating patients with sarcomas to the extent to which they have provided funds for those treating breast, lung, colon, and prostate cancers.

Yet that too is changing and more of the drug companies are working with the investigators who report their work at CTOS. But that provides a problem that has been handled really poorly.

Most of the presenters at CTOS lead with a title slide that also contains the names and affiliations of their co-authors.

The next slide, which stays on the screen for about three seconds, is the disclosures of the presenter, and only those of the presenter, not the co-authors, of the drug companies with which the presenter works. This attempt at subliminal obfuscation is supposed to excuse the fact that the relationship between the presenter and the drug companies goes largely undescribed. Why does that even matter?

In today’s world post the 1980 Bayh-Dole Amendment, many academic investigators have vested interests in the outcome of their own research. By vested, I mean money. They may hold stock in the companies for whom they are doing research. They may sit on the scientific boards of these companies and be paid for their service or be on a few speakers’ bureaus for which they are also paid. Are they truly independent scientists or shills for big pharma and how could anyone in the audience know which it is?

That’s the lesion. It is simply not enough to disclose that you work with an industry sponsor. An audience needs to know if you are getting rich based on the research results and thus are no longer an unbiased scientist but a part of the marketing arm of a drug company.

What struck me is how blasé all of the presenters are about these relationships. They are basically saying “trust me. I would never do anything to compromise my science like taking money for doing it, not to mention getting contract after contract from big pharma based on the results of the previous study.”

This is frankly outrageous and has to stop.

A good disclosure slide is a blank one. An investigator should be taking no money or any other perk from a sponsor of his or her own research other than the support for the research itself which goes to the investigator’s institution, not to him or her. The research is the research and the money is the money. They need to stay in separate pots except for the money supporting the research. That so many in academia do not see the conflict of interest into which they are entering and then dismissing on a three-second slide is dreadful.

Of course, every once in a while someone gets caught not disclosing their conflicts or having conflicts that could undermine their science or the transparency with which they present their prospective research to patients. But for most of the time, as was obvious in this meeting, they take the money, flash the slide and move on.

This is not academia’s finest hour.

Leonard Zwelling