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Sub-category:
Health Services Research
Category:
Health Services Research
Meeting:
2009 ASCO Annual Meeting
Abstract No:
CRA6509
Citation:
J Clin Oncol 27:18s, 2009 (suppl; abstr CRA6509)
Author(s):
S. Cheng, M. Dietrich, S. Finnigan, A. Sandler, J. Crites, L. Ferranti, A. Wu, D. Dilts; Vanderbilt University, Nashville, TN; National Cancer Institute, Bethesda, MD; Vanderbilt University Medical Center, Nashville, TN
Abstract:
Background: Post-activation barriers to oncology clinical trial accruals are well documented; however, potential barriers prior to trial opening are not. We investigate one such barrier: trial development time. Methods: National Cancer Institute Cancer Therapy Evaluation Program (NCI-CTEP) sponsored trials for all therapeutic, non-pediatric phase I,I/II, II, and III studies activated in an eight year period (2000-2007) were investigated (n=553). Successful trials were those achieving 100% of minimum accrual goal. Time to open a study was the calendar time from initial CTEP submission to trialactivation. Multivariable logistic regression analysis was used tocalculate unadjusted and adjusted odds ratios, controlling for study phase and size of expected accruals. Results: 40.0 percent (n=221) of CTEP-approved oncology trials failed to achieve minimum accrual goals, with 49.2 percent (n=30) of phase III trials failing to achieve at least 25 percent of accrual goals. A total of 8,723 patients (17.0% of accruals) accrued to those studies that were unable to achieve the projected minimum accrual goal. Trials requiring 9-12 months development were significantly more likely to achieve accrual goals (odds ratio, 1.94; 95% CI, 1.06 to 3.52, P=0.031) than trials requiring the median time (15-18 months); trials that exceeded 27 months of development time were significantly less likely of achieving accrual goals (odds ratio, 0.14; 95% CI, 0.04 to 0.54, P=0.004). Conclusions: A large percentage of oncology clinical trials do not achieve minimum projected accruals. Trial development time appears to be one important predictor of the likelihood of successfully achieving the minimum accrual goals.
Unadjusted and Adjusted Odds Ratio for Achieving Minimum Accrual Goals
| Development
Time Interval
(months) | Unadjusted Analysis
Odds Ratio
(95% CI);
P Value | Adjusted Analysis
Controlling for
Projected Minimum
Accrual Odds
Ratio (95% CI);
P Value | Adjusted Analysis
Controlling for
Phase of Trial
Odds Ratio (95% CI);
P Value |
| | [0,9) | 1.20 (0.55 - 2.59); P=0.650 | 1.17 (0.54 - 2.54); P=0.686 | 1.13 (0.52 - 2.46); P=0.758 | | [9,12) | 1.94 (1.06 - 3.52); P=0.010 | 1.96 (1.07 - 3.57); P=0.029 | 1.86 (1.02 - 3.40); P=0.044 | [12,15)
(referent) | 1.0 | 1.0 | 1.0 | | [18,21) | 0.52 (0.27 - 1.00); P=0.051 | 0.54 (0.27 - 1.05); P=0.068 | 0.55 (0.28 - 1.07); P=0.078 | | [21,24) | 0.78 (0.39 - 1.57); P=0.482 | 0.78 (0.38 - 1.57); P=0.478 | 0.75 (0.37 - 1.53); P=0.435 | | [24,27) | 0.52 (0.20 - 1.35); P=0.179 | 0.54 (0.21 - 1.40); P=0.205 | 0.53 (0.20 - 1.37); P=0.191 | | [27,30) | 0.14 (0.04 - 0.54); P=0.004 | 0.15 (0.04 - 0.58); P=0.006 | 0.16 (0.04 - 0.59); P=0.006 | | [30, ) | 0.17 (0.07 - 0.41); P<0.001 | 0.18 (0.07 - 0.44); P<0.001 | 0.19 (0.08 - 0.46); P<0.001 |
| | Referent indicates median development time of all clinical trials in the sample |
Abstract Disclosures
Faculty and Discussant Disclosures
Annual Meeting Planning Committee Disclosures
2009 Annual Meeting Proceedings Part I Errata
Abstracts that were granted an exception in accordance with ASCO's Conflict of Interest Policy
and are designated with a caret symbol (^) here and in the print version.
 Associated Presentation(s):
Other Abstracts in this Sub-Category:
Abstracts by S. Cheng:
Presentations by S. Cheng:
Educational Book Manuscripts by S. Cheng:
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