A Washington Post live event entitled Chasing Cancer was held in Boston, Massachusetts, US, on 4 September, to consider strategies to improve the delivery of cancer therapies to patients.
The event gathered physicians, clinical researchers and cancer survivors to discuss drug development trends and access issues, as well as to formulate strategies around these topics.
One of the main topics of discussion was accelerating the delivery of innovative medicine to patients. The discussion was focused on the decreasing involvement of patient participation in clinical trials and mitigation efforts taken by cancer research institutes and pharmaceutical companies.
Key opinion leaders noted potential strategies to solve these issues, such as adopting new diagnostic technologies, incorporating artificial intelligence in clinical trial design, creating awareness of clinical trials, and integrating trials into patients’ lives. Recent trials are more patient-centric, including trial participation across diverse patient groups and including patients’ voices in trial design.
Barriers affecting participation in trials include lack of awareness, inconvenient location of trial sites, and complex clinical trial design, which leads to lower retention rate. With the development of precision medicines and more personalised treatment options for patients, there is a need for a larger number of patients to be enrolled in these clinical trials, especially with representation from minority communities to mimic the actual global population distribution.
Access to clinical trials
To increase enrolment, the Lazarex Foundation and Amgen have jointly initiated the Impacting Patient Access to Cancer Clinical Trials (iMPACT) programme, which primarily focuses on increasing patient enrolment, increasing retention of patients in clinical trials, and increasing minority patient participation through specific financial reimbursement programmes for consenting participants. Apart from various institutions and hospitals working to accelerate delivery of innovative medicines to patients, big biopharmaceutical companies like Amgen have previously initiated several key programmes for their personalised cancer treatments and will continue to do so in the future.
Amgen is pursuing multiple approaches to mitigate the previously mentioned barriers for patient participation in clinical trials through the incorporation of smart trial designs. Examples of this include reducing non-essential components in trials to reduce complexity, utilizing single-arm trials based on the historical data for the particular drug/indication, partnering with other companies to collect data to make better predictions about trial design and execution, using minimal residual disease (MRD) as an endpoint for approval in certain cancer types where endpoints such as overall survival take longer to collect data, and integrating patients’ voices in clinical trial design.
Due to advancements in medicine and shifts in oncology treatment regimens, there is a need to develop and adopt new clinical trial methods, as the drugs in recent development are more targeted and incorporate biomarker strategies to create higher clinical value. This validates the need for many participants, which strengthens the safety and efficacy data for these drugs before launch and impacts patients’ lives across the globe.
GlobalData (2018) Gene Therapy in Oncology, June 2018, GDHCHT004