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Institute of Medicine Report on Clinical Cancer Trials

Last month, the Institute of Medicine issued a report on the state of clinical cancer trials in the United States.  The report, A National Cancer Clinical Trials System for the 21st Century: Reinvigorat­ing the NCI Cooperative Group Program, reviewed the process of the trials and the stakeholders in the trials and found that the process was inefficient in how it developed, launched, and conducted clinical trials, an inefficiency which often leads to long delays.  In its editorial concerning the IOM’s report, The New York Times said the system was in a “state of crisis” and the IOM report was a “disturbing verdict.”  The editorial continued: “Unless the shortcomings are remedied, some of President Obama’s ambitious health care reforms will be jeopardized and his audacious goal of finding ‘a cure for cancer in our time’ will have almost no chance at all.”  The Times found the “most shocking deficiency” was that around “40 percent of all advanced clinical trials sponsored by the Cancer Institute are never completed.”  This, The Times stated, was “an incredible waste of effort and money, and a huge obstacle at a time when researchers are developing promising new therapies that must be rigorously tested.”

As part of its report, the IOM provided a series of recommended changes across the board to promote the effectiveness and efficiency of clinical cancer trials:

1)      Improve the speed and efficiency of the design, launch, and conduct of clinical trials.

2)      Make optimal use of scientific innovations.

3)      Improve the selection, prioritization, support, and completion of clinical trials.

4)      Foster the expanded participation of both patients and physicians.

The IOM report concluded by calling for the implementation of its recommendations to reinvigorate cancer trials: “treatments for cancer will be delayed and patient lives will be lost unnecessarily unless the efficiency and effectiveness of the clinical trials sys­tem improves.”  All stakeholders, the report stated, “including physicians, patients, and health care insurers, as well as NCI, other fed­eral agencies, academia, foundations, and industry, must reevaluate their roles and responsibilities in cancer clinical trials and work together to develop an improved, efficient multidisciplinary trials sys­tem.”  As The New York Times reiterated, “the health of nearly 1.5 million patients diag­nosed with cancer in the U.S. each year depends on these efforts.”

A National Cancer Trials System for the 21st Century, Report Brief: http://www.iom.edu/~/media/Files/Report%20Files/2010/A-National-Cancer-Clinical-Trials-System-for-the-21st-Century-Reinvigorating-the-NCI-Cooperative/NCI%20Cancer%20Clinical%20Trials%202010%20%20Report%20Brief.ashx

The New York Times editorial, “Faltering Cancer Trials,” (April 24, 2010): http://www.nytimes.com/2010/04/25/opinion/25sun1.html?scp=2&sq=Cancer&st=nyt

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