Self-Reported Conflicts of Interest of Authors, Trial Sponsorship, and the Interpretation of Editorials and Related Phase III Trials in Oncology Giovanni M. Bariani, Anezka C.R. de Celis Ferrari, Paulo M. Hoff, Monika K. Krzyzanowska, and Rachel P. Riechelmann See accompanying editorial doi: 10.1200/JCO.2013.48.8817 Giovanni M. Bariani, Anezka C.R. de Celis Ferrari, Paulo M. Hoff, and Rachel P. Riechelmann, Instituto do Ca ˆncer do Estado de Sa ˜o Paulo, Sa ˜ o Paulo, Brazil; and Monika K. Krzyzanowska, Princess Margaret Hospital, Toronto, Ontario, Canada. Published online ahead of print at www.jco.org on April 29, 2013. Presented at the 48th Annual Meeting of the American Society of Clinical Oncology, Chicago, IL, June 1-5, 2012. Authors’ disclosures of potential con- flicts of interest and author contribu- tions are found at the end of this article. Corresponding author: Rachel P. Riechelmann, MD, PhD, Clinical Research Unit, Instituto do Ca ˆncer do Estado de Sa ˜ o Paulo, Av. Dr. Arnaldo 251, 12° andar, 01246-000 Sa ˜o Paulo SP, Brazil; e-mail: rachel.riechelmann@ icesp.org.br. © 2013 by American Society of Clinical Oncology 0732-183X/13/3199-1/$20.00 DOI: 10.1200/JCO.2012.46.6706 A B S T R A C T Purpose Growing participation by industry in cancer research has resulted in increased reporting of conflicts of interest (COI). We aimed to test any association between authors’ conclusions and self- reported COI or trial sponsorship in cancer studies. Methods Editorials and related phase III trials published in six clinical oncology journals in the last 3.5 years were analyzed independently by two investigators who classified study conclusions according to authors’ endorsement of the experimental therapy. Logistic regression multivariable models were used to assess predictors of favorable conclusions of editorialists and of phase III authors. Results From January 2008 to October 2011, 1,485 articles were retrieved: 150 phase III trials and 150 editorials were eligible. Among the phase III trials, 82 (54.7%) had positive results, and 78 (52.0%) were entirely or partially funded by industry. Any COI were disclosed in 103 phase III trials (68.7%) and in 71 editorials (47.3%). Multivariable analysis showed that phase III trial results were the only significant predictor for a positive conclusion by trial authors (odds ratio [OR], 92.2; 95% CI, 19.7 to 431.6; P  .001). Sponsorship did not predict for positive conclusion by phase III authors (OR, 0.86; 95% CI, 0.3 to 2.5; P = .788). The only factor associated with positive conclusions by editorial authors was a positive conclusion by phase III trial authors (OR, 36.3; 95% CI, 6.8 to 194.2; P  .001). Conclusion The interpretation of recently published phase III cancer trials by their authors or by editorialists was not influenced by financial relationships or industry sponsorship. Increased awareness of COI policies may have led to more integrity in cancer research reporting. J Clin Oncol 31. © 2013 by American Society of Clinical Oncology INTRODUCTION Pharmaceutical industry collaboration in clinical re- search has increased over time, 1 particularly in on- cology. 2 Performing cancer clinical trials requires significant financial resources, which makes indus- try sponsorship almost a necessity. Likewise, newly approved cancer drugs are expensive, making the development of cancer drugs an attractive field for industry investment. Consequently, financial ties between sponsors and investigators have become common in oncology. In a cross-sectional survey of studies published in the Journal of Clinical Oncology (JCO) in 2005, at least one financial relationship between authors and pharmaceutical companies was disclosed in 69% of trials and in 51% of editori- als. 3 Another study showed that 58% of trials pub- lished in JCO in 2005 and 2006 had at least one author who disclosed any monetary relationship with industry. 4 Obviously, such widespread finan- cial ties of authors with industry have concerned the community about their influence on research devel- opment and interpretation. 5-7 Conflicts of interest (COI) is a widely used term to denote the presence of secondary interests, usu- ally financial, between industry and authors of clin- ical research. 8 Since 1997, the International Committee of Medical Journal Editors has rec- ommended the publication of source of funding and financial ties between authors and sponsors in an attempt to control for bias. 9 However, COI of investigators with for-profit organizations have JOURNAL OF CLINICAL ONCOLOGY O R I G I N A L R E P O R T © 2013 by American Society of Clinical Oncology 1 http://jco.ascopubs.org/cgi/doi/10.1200/JCO.2012.46.6706 The latest version is at Published Ahead of Print on April 29, 2013 as 10.1200/JCO.2012.46.6706 Copyright 2013 by American Society of Clinical Oncology