Cancer clinical trials continue to be the gold standard by which new preventive, treatment, supportive care, and other interventions are tested and compared with existing interventions. New clinical trial designs are emerging with the recognition that a single cancer type may consist of many different molecular subtypes and that a given molecular alteration may drive many different types of cancer. At the same time, it is important that more patients have the opportunity to enroll in trials, to ensure that the results of trials are as broadly applicable as possible and that answers are obtained as quickly as possible.
The submission period for Expanding Clinical Trial ideas ended on July 1. However, we encourage you to sign up for regular e-mail updates about the National Cancer Moonshot Initiative at the Cancer Moonshot Milestones web page.
We study cancer in narrow cohorts, excluding comorbidities. By doing so we miss critical info that can lead to earlier identification/treatment. While we must stratify samples, we can do so and include comorbidities that lead to disease pathways.
If data collection is restricted to the US, we may mischaracterize some familial cases as sporadic. We need to include Family History in the NIH/FDA Clinical Trial protocol template (sec.7.1.1) and provide global access to registries/biobanks.
A novel, breast stereotactic radiotherapy device is now undergoing testing on an FDA approved investigation device exemption protocol. This device has immense potential as a one day, noninvasive, curative treatment for early stage breast cancer.
HAMLET detects and binds to tumorcells. Inject HAMLET directly into metastasis in for example skeletton, muscle, liver, brain to prolong survival for cancerpatients and hopefully in some cases cure the patients.
ARR Recommendation
ARR Recommendation
Research is needed to understand how potential participants perceive risks and benefits of participation in RCTs in order to increase recruitment, especially among older participants and those in underserved communities.
The needs, preferences, and values of cancer patients should be incorporated into clinical research studies. This approach could facilitate adherence of currently enrolled clinical trial patients as well as recruitment of new enrollees.
Low and/or slow accrual to clinical trials is a critical barrier to making advances in cancer treatment. Improving access to trials and medical oncologists referrals to centers offering clinical trials would greatly speed up our progess.
Flip the clinical trial enterprise from trial-centric to patient-centric by bring the trial to the patient. Currently we are trial focused for accrual. We need to focus on patients to find the right trial for them and enable access to that trial.
Create "clinical trial finder" regional centers staffed with healthcare personnel trained to help patients assess best clinical trial option anywhere in US--not only identify trials, but choose best trial option and together with patient
Train doctors at community-based hospitals to act as local "hands-on" clinical trial check-in locations so trials for rare and oncogene-driven cancers will increase accrual (and more patients will have access)
Chemotherapy typically involves maximum tolerated doses. These high doses cause severe adverse effects and morbidity. Metronomic dosing of chemotherapy is generally better tolerated and may also be more effective at reducing tumor burden.
Chemotherapy typically involves maximum tolerated doses. These high doses cause severe adverse effects and morbidity. Metronomic dosing of chemotherapy is generally better tolerated and may also be more effective at reducing tumor burden.
Develop infrastructure to support clinical trials for early stage cancers that a) help evaluate novel treatments based on genomically driven targets and b) develop methods to rapidly screen novel compounds against the patient’s tumor genetic profile.