As scientists and physicians, we all strive to improve the outcome for cancer patients. But the challenge is great. The disease that we are seeking to impact represents years of evolutionary selection. It is exceedingly complex. It displays remarkable heterogeneity, and the models that we employ are overly simple and highly contrived. These are difficult issues to address.
However in addition to the challenge intrinsic to the disease itself is the challenge that we have within our current scientific system. Although difficult, this challenge is much more readily addressed.
Unfortunately the majority of publications in 'top-tier' journals are not able to be reproduced, even by the investigators themselves. The reasons for this are typically poor scientific methodology (lack of blinding; use of non-validated reagents; lack of positive and negative controls; failure to repeat experiments; inappropriate use of statistics; selective presentation of data). This failure to embrace what would commonly be regarded as standard scientific method is driven by the perverse incentives within our system: publications in top-tier journals drive grant success, fame and fortune. Thus there is a haste to publish.
This fundamental conflict of interest on the part of each scientist is seldom articulated and almost never addressed, yet the responsibility for appropriate design, execution, interpretation and presentation of data rests principally with the investigator. Others also share some responsibility including the host Institution, funding agencies and journal editors, and some in the latter two groups are beginning to make changes accordingly.
Examples of the types of problems that are endemic to our system will be presented, and measures that are underway to address these concerns will be discussed.