Triumphing in trials

There are certain firsts and lasts that we all remember: your first teacher, your first car, your first kiss. One first I’ll always remember is seeing three doctors at ASCO writing the protocol for a trial design on the back of a napkin. Thankfully, it was the last time, too, and patient-centric trial design across therapeutic areas has moved on a lot since then, particularly in oncology.

But with cancer remaining as one of the most prevalent and deadly forms of disease worldwide, there are a staggering number of clinical trials vying for attention. This presents a significant challenge for patients: with so many trials, how do they understand which they should be pushing to be a part of, which they are suitable for and, more crucially for them, which will offer hope?

Maybe in the future, patients will have improved access to clinical trials and drug developers will be able to find suitable participants more easily. But for now, that’s not possible and that’s one of the many reasons why active, meaningful patient engagement is essential from the beginning.

Recognising the problem

Beyond patient recruitment into the study, there is widespread acceptance among pharma companies that failing to meaningfully engage patients, their clinicians, and advocacy groups can also lead to poor retention rates amongst an already limited pool of eligible participants. With delays in the development of new drugs costing anywhere from $500k to $8M per day,¹ not getting recruitment right really impacts a company’s bottom line.

But knowing what you need to do and knowing how to do it are two different things, so here are some guiding principles.

Thinking things through: Solutions that sow seeds of success

Access: Most patients are not treated at centres of excellence where studies are typically conducted; instead, they receive care in community hospitals or clinics, remaining unaware of available trials and potentially life-saving therapies. It may not always be possible to move trials, but consider how you might inform a broad pool of geographically diverse patients of their eligibility for your trials and how you can help patients get to them.

Education: The prospect of late-stage trials can be intimidating for many patients, but clear translation of complex science, protocols, and endpoints can prove the difference between a hopeful enrolment or a frightened refusal. Whether via one-to-one communication or through meeting with patient groups, being a thoughtful partner that provides support, reassurance, and guidance leads to higher level of engagement with key stakeholders.

Partnerships: We owe it to patients to learn about their challenges and provide a safe space for them to ask questions, but we must also understand the entire ecosystem of their disease and create a better experience for them. That means identifying and working with appropriate partners, such as caregivers and advocacy groups, to better collate insights and shared experiences that help to holistically inform a protocol.

Reimbursement strategies: At a time in their life when many cancer patients already have plenty of worries, asking them to self-fund things like travel, childcare, and food to attend an appointment can be a significant upfront cost. With households across the world feeling the financial pinch more than ever, patients need to see you alleviate burdens from their lives from the very first interaction - not leave them worrying if they can afford the upfront cost of trial enrolment. Simple things like booking their travel for them and providing an up-front per-diem can be deciding factors on whether a patient thinks your trial is accessible or not.

Closing the loop: If I spent an hour a week for six months watching you, taking samples and analysing them, you’d want to know the ultimate outcome – and patients do too. They want to feel that their contributions to trials will be making a difference to them or impact future treatments. By sharing outcomes with participants, you not only build trust, but also encourage them to recommend you as a company aligned with the needs and priorities of patients, irrespective of your specialised therapeutic area.

All trial, no error

The challenges facing oncology clinical trials are multifaceted, but there is a clear opportunity for pharmaceutical companies to rethink their approach to clinical research. Embracing the basics of supportive patient engagement allows you to prioritise patient perspectives from the very beginning, which not only enhances the patient experience, but is crucial to the innovation that drug developers strive for every single day.

As we move forward into 2025, let us remember that at the heart of every clinical trial is a patient seeking healing or hope.