Cancer clinical trials--do we need a new algorithm in the age of stratified medicine?

Program management challenges of clinical studies: A qualitative critical assessment

Background

Organization, coordination, and discipline are required to complete any intricate operation, conducting a clinical experiment is no different. There are usually many moving components, from designing a plan, to conveying changes, to calculating risk, and excellent project management which are necessary to guarantee the study works successfully. Past evidence suggested that roadblock at any level hampers the progress of the clinical research. Understanding program management challenges hence becomes the key for timely and effective completion of clinical research.

Methods

A cross-sectional qualitative enquiry involving stakeholders in clinical research program management. We used problem tree-based approach wherein we documented views of various stakeholders to understand the interaction, interdependence, and related interventional needs of bottlenecks for long-term research gains using modern management methods applicable in clinical settings. The best fit approach was also explored to augment maximum benefit in limited resource settings.

Results

Non-alignment with state policy aims, a lack of effective coordination and communication among members, challenging logistic management, limited use of technology, a need for training, and an inefficient monitoring mechanism were among the major issues highlighted, and solutions were proposed.

Conclusion

Study concludes that an Integrated Process-cum-Timeline-Based Management strategy with multisectoral emphasis is ideal for program management of clinical projects.

Delivering a research-enabled multistakeholder partnership for enhanced patient care at a population level: The Northern Ireland Comprehensive Cancer Program

The last 20 years have seen significant advances in cancer care in Northern Ireland, leading to measureable improvements in patient outcomes. Crucial to this transformation has been an ethos that recognizes the primacy role of research in effecting heath care change. The authors' model of a cross‐sectoral partnership that unites patients, scientists, health care professionals, hospital trusts, bioindustry, and government agencies can be truly transformative, empowering tripartite clinical‐academic‐industry efforts that have already yielded significant benefit and will continue to inform strategy and its implementation going forward.

Increasing the number of clinical trials available to adolescents diagnosed with cancer

Improving access to clinical trials for adolescents with cancer remains an important issue for pediatric health care providers. In this brief report, we highlight barriers to increasing the number of clinical trials as a mechanism for addressing this problem. The challenges discussed include: (1) engaging stakeholders to increase funding; (2) increasing cooperation between clinical trial cooperative groups; and (3) permitting delivery of novel drugs to postpubertal adolescents, in the absence of formal pediatric Phase I evaluation.