Speculation.
> Nobody really cares or pays much attention.
Maybe they should.
>When it comes to clinical trials, there are many checks and balances that prevent a 'rogue' conflicted investigator from influencing the results.
And you think these checks and balances work good enough, most of the time?
Having come from acedemia, I disagree with just about everything in this post. People do care about conflicts of interest and when very powerful people are being reviewed, they get greater leeway because of the power of retribution.
Clinical trials have standardised designs and procedures, the number of experimental subjects is large (compared to preclinical lab experiments), and orthogonal outcome measures are collected to enhance validity (like response rate and survival outcomes). Most doctors are trained and experienced in interpreting clinical trials, and are well aware of the limitations, which are constantly highlighted in conference discussions and the literature.
Finally, clinical trials are replicated all the time (surprised you would suggest otherwise?). A drug is tested in phase 1, phase 2 and phase 3 trials of increasing size, and drugs from the same class are also tested in competing trials.
If he had disclosed all his conflicts, the same research would have been published in the same places with the same people. Nothing would have changed. At conferences academic oncologists get up and flash a slide with many conflicts of interest at the start of their talk. Nobody really cares or pays much attention.
When it comes to clinical trials, there are many checks and balances that prevent a 'rogue' conflicted investigator from influencing the results. Not the least of these are the other investigators on the study which put their name on the paper, who are free thinking individuals. The data is also collected and analysed by an independent data monitoring committee, who will for example stop the study early if it is looking futile, whatever the drug company thinks should happen. Independent clinical trial staff will also send out teams to hospitals running the trial and inspect the data and talk to the staff. For trials going for regulatory approval of the drug, there is often a formal independent audit which goes even deeper, to the point of interviewing staff in a confidential setting and asking them if they have been coerced for example.