A Patient Centered Approach to Enrolling Rare Cancer Patients in Clinical Trials

DESCRIPTION (provided by applicant): The American Cancer Society estimates that more than 1.5 million new cancer victims will be diagnosed this year in the U.S., and that ~572,000 Americans will die of cancer in 2011.1 More than 13 million Americans are living today with a history of cancer, and this number is heading toward 18 million by 2020.1 Beyond the human costs in lives, productivity, and quality of life, the NIH estimated cancer's direct medical costs t 103 billion in 2010, with total costs being263 billion.1-2 Clearly, adequate drug therapy is not yet available, and we need better ways to rapidly develop and test new drugs. At the heart of the problem is a one size fits all approach to research that is not aligned to a cancer population comprised of hundreds of rare treatment indications spread among thousands of separate practices? Innovations are needed to deliver greater access to patients and to connect the right patients to the right clinical trials at the right time. We need to get next-generation cancer drugs from benchtop to the clinic-faster and at a lower cost-and the Obama administration's ambitious plans to double federal funding for cancer research within five years and to also double enrollment in U.S. cancer clinical trials is certainly in jeopardy given the current budget situation.3 Pharmatech Oncology is addressing this critical need via research system innovations that increase access to patients for participation in clinical trials. Our Just-n-Time (JIT) research system being developed in this multi- phase SBIR project is designed to closely align and coordinate U.S. clinical research with cancer patient care. Our strong Phase I results demonstrate that the feasibility of using JIT is a superior methodology for conducting clinical trials in indications where patients are potentially rare and highly embedded in a large care system. Those results set the stage for this Phase II project, which is focused upon completing the system development, optimization, standardization, and customer interactive infrastructure needed to offer the JIT research service through a website portal product, the Pharmatech Nexus. The Pharmatech RandD team will pursue the following Phase II Aims: 1) Develop and demonstrate optimized JIT workflow andeconomics at research site level; 2) Develop and implement tools to standardize the JIT methodology; 3) Develop a business platform to drive scalability and expanded connectivity; and 4) Prove the integration of JIT methodology with molecular screening. Building on the concepts proven in Phases I and II, a new means of conducting clinical trials will be made broadly available. When fully developed by the expert Pharmatech team, the Pharmatech Nexus platforms will 1) make a large number of clinical trials,spanning multiple indications and treatment stages, available to oncologists for their patients; 2) provide a conduit for molecular testing to identify which targeted investigationl therapies may be appropriate; and 3) enable individual patients to enrollin the right trials very quickly and to receive research-based care on a schedule that accommodates their need to be treated. PUBLIC HEALTH RELEVANCE: As more-effective precision therapeutics become available to directly target the molecular causes of cancers, the costs and challenges of bringing a new generation of highly effective drugs from benchtop to clinic are escalating. The end goal of this multi-phase SBIR project is to establish a new, patient-centered clinical research system that is aligned with cancer patient care in the U.S. and to vastly expand patient/physician access to clinical trials as treatment options for individual patients. The Phase II work proposed here will position Pharmatech Oncology to lead a unique, collaborative marketplace initiative designed to drive cancer patient participation in clinical trials from 3% to 10% by 2020, enabling approval of next-generation cancer drugs more rapidly and at a lower cost.