Association between conflict of interest and published position on tumor-treating fields for the treatment of glioblastoma

Objective: To investigate a possible association between authors' financial conflict-of-interest and published position on the clinical application of a medical device utilizing tumor-treating fields (TTF) for the treatment of Glioblastoma. Methods: We searched Google Scholar for all articles that cite the 2015 JAMA article on TTF in treating glioblastoma. All articles were read in full to identify editorials or review articles that focus on the use of TTF in treating glioblastoma. Selected articles were coded by two investigators as favorable toward the use of TTF, or neutral/unfavorable. Conflict-of-interest as declared by each author was recorded, and The CMS Open Payments Registry was used to independently identify conflict for each listed author of included articles. Results: There were 15 articles with 44 independent authors included in our analysis. Of the 15 articles, nine articles were categorized as favorable with 35 authors. Of the 35 authors with favorable views, 77% (26/35) had financial conflict-of-interest with the maker of TTF, compared to 11% (1/9) of authors of neutral articles. Authors of articles with a favorable stance towards TTF were more likely to have received payments from the device manufacturer worth greater than 1 000 dollars than authors of neutral articles (66% vs. 0%, p=0.001). Among the nine favorable articles, 89% (8/9) had at least one author who had received greater than 1 000 dollars from the device manufacturer. Conclusion: Our study shows an association between authors' published stance on the use of tumor-treating fields for the treatment of glioblastoma and financial ties to the manufacturer of this device.