Evaluating Conflicts of Interest in Academic Research On Erythropoietin Receptors in the Cancer Setting

We previously reported that among preclinical cancer articles published prior to 2008, academic researchers without financial conflicts of interest were significantly more likely than academic researchers with financial conflicts or researchers employed by erythropoiesis stimulating agent (ESA) manufacturers to identify erythropoietin (Epo)-induced cancer-related signaling events and Epo-induced changes in functions of cancer cells.(Arch Int Med 2010) In 2007, the National Cancer Institute convened a workshop on Epo-receptors for 14 academic researchers and six researchers employed by ESA manufacturers. We update our analysis following this workshop.

Articles identified in MEDLINE and EMBASE databases (1989–2012) investigating preclinical ESA findings were reviewed. Outcomes included Epo-receptors, Epo-induced signaling events, Epo-induced cellular function events, and qualitative conclusions among reports published since the 2007 meeting. Recent publications before versus after the NCI workshop according to source of research funding were analyzed. Outcomes were reported according to academic investigators without financial conflicts of interest (26 publications post-2008; 64 publications pre-2008), academic investigators with financial conflicts (5 versus 7 publications) and investigators employed by ESA manufacturers (2 versus 3 publications).

Since 2008, academic investigators without financial conflicts of interest and academic investigators with financial conflicts differed from researchers employed by ESA-manufacturers with respect to identifying the following EPO-induced events: signaling associated with tumor promotion (86%, 100%, versus 0%; p=0.06), cellular function changes associated with tumor growth/metastases (86%, 67%, and 0%; p=0.06). We qualitatively concluded that preclinical findings raised concerns that ESAs could be harmful clinically (77%, 40%, and 0%, p=0.03). Prior to 2008, academic investigators without financial conflicts of interest differed from academic investigators with financial conflicts and researchers employed by ESA manufacturers for these same outcomes (signaling events, 94%, 0%, and 0%, p=0.001; cellular changes (57%, 0%, and 0%, p=0.007), and qualitative conclusions regarding potential harm (57%, 0%, and 0%, p=0.007), respectively.

The potential for conflicts of interest to affect preclinical research findings dissipated, following an NCI-convened workshop, for academic researchers with financial conflicts of interest, but not for researchers employed by ESA manufacturers.

Bialkowski:Eli Lilly: family member employment Other. Sartor:Amgen: Consultancy.