Cancer trial sites are growing, but poor performance is, too: report

Clinical trial sites for cancer are proliferating, but a lack of investigators with experience in trial recruitment is weighing on their performance, according to a report released May 23 by trial analytics company Phesi.

“There has been rapid progress in precision medicine, but the same level of precision is not yet given to investigator site selection and country allocation,” Gen Li, Ph.D., president at Phesi, said in the report. “The saturation of investigator sites in certain areas increases the number of non-performing and poor performing sites, resulting in trial failures.” 

The latest analysis included 11,755 phase 1, 2 and 3 oncology clinical trial sites. The good news is that the number of sites is up 49% since 2019. Much of that expansion can be attributed to China, which still has fewer oncology trial sites than the U.S. but now has nearly four times as many as it did five years ago, by far the biggest increase on a per-country basis. Asia in general has the most nations among the top five in terms of growth: Korea is No. 4 with an 80% increase, while Taiwan sites grew 69% to come in at No. 5. U.S. trial sites grew 21% since 2019. 

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On the other hand, the number of underperforming sites has grown, too, a problem that Phesi pegged as a contributor to trial failures. Using 471 phase 1 non-small cell lung cancer clinical trials as an example, Phesi reported that a fifth of the investigators working on the trials had no history of “strong recruitment” in lung cancer studies and, in fact, specialized in different areas of oncology. The firm’s analysis also showed that the largest 100 lung cancer investigator sites in the U.S. each recruit for 39 trials on average. 

“A single investigator cannot meaningfully recruit patients for 39 trials and, for this reason, overly burdened investigator sites will predictably have a detrimental impact on oncology clinical development,” the report reads. 

Phesi conducted the research using its Trial Accelerator platform, which uses artificial intelligence to analyze data from 108 million patients across 195 countries.

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