Oncology Clinical Research
Oncology continues to be one of the most active therapeutic areas in clinical trials. With significant funding from industry and federal agencies, the field is often the first to investigate new treatment modalities, technologies, and discoveries.
With this tradition of innovation comes the challenge of determining how new approaches fit into regulatory plans, clinical operations, and more.
Current Trends and Challenges in Oncology Clinical Research
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Personalized medicine and cell and gene therapies
The rise of genetic sequencing has inspired researchers to explore more personalized ways to combat cancer. Investigational treatments involving genetic engineering and gene therapies may offer more targeted ways to treat an individual patient.
Utilizing biologics to attack specific cancer cells, these custom therapies can be more challenging to manufacture. They have regulatory requirements and biosafety concerns beyond traditional drug development requirements.
Sites also face unique recruitment challenges in finding the right potential participants for highly targeted investigations.
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Immunotherapy
Cancer treatments leveraging the body’s immune system have become increasingly popular in research and clinical settings. Researchers continue to expand and improve the techniques, like overcoming immunotherapy resistance, predicting patient response, and learning from cancer cells’ attack strategies.
Not all patients respond to immunotherapy treatment, and those who do may face significant financial costs.
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Complex protocol design
Oncology clinical research often requires complicated study designs to appropriately evaluate efficacy. Such protocol designs can also help address the heterogeneous complexities of tumors. They may also be necessary when drug combinations are used.
Master protocols can provide flexibility as data are collected. These study designs (e.g., basket, umbrella, and platform trials) allow for evaluating more than one research question in concurrent sub-studies.
While complicated from a data evaluation perspective, these studies can help improve enrollment, making cancer research more accessible to diverse populations.
How is the oncology clinical research community addressing diversity, equity, and inclusion (DE&I)?
Technology for Conducting Oncology Clinical Trials
Recruitment and retention are particularly challenging when working with very specific inclusion and exclusion criteria. Managing research data can also be difficult, as sites must meet additional reporting requirements from the National Cancer Institute (NCI). And because cancer patients often face grave diagnoses, extra care must be taken to ensure they truly understand what study participation requires.
To find sites with access to the right patient populations, sponsors, and contract research organizations (CROs) may choose to inform feasibility and site selection with site performance data.
Technology like a clinical trial management system (CTMS) can help research sites better manage study activities and report on oncology research data. Automating certain tasks can also help make more time available to focus on participants. However, when sponsors mandate study-specific technology to manage their cancer trials, sites may find the myriad systems a burden. 78% of NCI-designated clinical research sites use Advarra’s OnCore CTMS.
For sites outside of the U.S., sponsors should ensure they provide site-centric and integrated tools to support sites conducting complex research.
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Compliance and Safety in Oncology Clinical Research
Clinical trial safety and compliance are paramount for every type of study, but oncology trials also have special concerns specific to the field.
- Institutional review boards (IRBs) often have unique considerations with oncology protocols, as risk/benefit evaluations may be different from other therapeutic areas.
- The growing number of sIRB requirements for multisite studies adds challenges for institutions historically reliant on local IRB review and lacking sIRB processes.
- Phase I oncology trials in particular have unique ethical concerns to manage, given their role in collecting initial clinical safety data.
- NCI-designated cancer centers must meet additional requirements to maintain that designation.
- Cancer trials involving cell and gene therapy likely require institutional biosafety committee (IBC) review (in addition to IRB review), requirements which may be unfamiliar to those new to genetic research.
- Most cancer clinical trials require data safety monitoring board (DSMB) oversight, which must remain independent of study conduct to provide unbiased recommendations regarding safety signals and trends.
- Specialized medical expertise may be needed to ensure data are reviewed appropriately when assessing whether a study event is related to the research and/or its defined endpoints.
Advarra’s Contributions to Oncology Research
of industry-initiated oncology trials in North America rely on Advarra solutions
of NCI designated cancer centers conducting clinical trials are supported by Advarra’s IRB
of NCI designated cancer centers manage their trials with OnCore CTMS
Read our Related Resources
Oncology Innovations and Other Trending Topics from IRB Experts
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Diversity in Cancer Research: Getting Started
Learn how to start ensuring the membership and leadership of your NCI-designated cancer center reflect the population you serve.
Unique Ethical Issues in Phase I Oncology Studies
An essential step in research, Phase I oncology studies raise unique ethical challenges for sponsors, investigators, and IRBs.