CTTI’s New Recommendations for Data Monitoring Committees

Today, CTTI unveiled new recommendations on best practices for the use of Data Monitoring Committees (DMCs), an important approach to ensure the validity and integrity of a clinical trial when there is a need to periodically review accumulating safety and efficacy data and advise on whether to continue, modify, or terminate a trial based on the benefit-risk assessment.

CTTI recommendations are intended to enhance the functioning of a DMC, beginning with the training of members. Other issues addressed by CTTI include the role and responsibilities of the DMC, composition of members, development of a charter, and communication with the trial sponsor and others. The recommendations were presented during a session at the Society of Clinical Trials (SCT) annual meeting. Dr. David DeMets, a thought leader on DMCs, chaired a session that also included project team members Karim Calis of FDA, Raymond Bain of Merck Research Laboratories, and Annemarie Forrest of CTTI.

As noted by Dr. Calis,
“DMCs play a unique and critical role in trial oversight. The clinical trial enterprise–including investigators, sponsors, trial participants, and other stakeholders–benefits greatly from having strong, independent DMCs that have adequate resources and sufficient flexibility to carry out their important mission.”

The full recommendations are available on the CTTI website and will also be presented in a CTTI-hosted free, public webinar on June 16, 2016 from 12:00 – 1:00 PM EST (New York, GMT-04:00). See below for additional details on this upcoming webinar:

Speakers:

  • Dave DeMets, PhD, Professor and Chair of the Department of Biostatistics and Medical Informatics, University of Wisconsin – Madison
  • Jane Perlmutter, PhD, Patient Advocate
  • Karim Calis, PharmD, MPH, FASHP, FCCP, Office of Medical Policy, Center for Drug Evaluation and Research, U.S. Food and Drug Administration

Meeting Link:  Click here to join WebEx meeting on June 16
Meeting number: 732 840 380
Meeting password: DMCctti

Or join by phone only:
1-855-244-8681 Call-in toll-free number (US/Canada)
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Access code: 732 840 380

CTTI Presents at Society for Clinical Trials Annual Meeting

There will be several opportunities to learn how CTTI recommendations can improve quality and efficiency of your clinical trials at the Society for Clinical Trials (SCT) 37th Annual Meeting, taking place May 15-18, 2016. Presentations will include the release of recommendations from the Data Monitoring Committees Project, as well as tips for collaborating with patient groups when designing clinical trials. CTTI will also have two posters for viewing: one on improving the informed consent process and one on how CTTI is improving the quality and efficiency of clinical trials.

If you are attending the conference, we invite you to stop by and learn more:

SCT 37th Annual Meeting

Presentation: Recommendations from the Clinical Trials Transformation Initiative Data Monitoring Committee Project
Date & Time: Monday, May 16, 2016, from 10:45 AM-12:15 PM EST
Speakers: Dave DeMets, Karim Calis, Ray Bain, Annemarie Forrest

Click here to learn more about the DMCs project.

 

Poster: CTTI’s Recommendations for Improving Informed Consent
Date & Time: Monday & Tuesday, May 16 – 17, 2016
Speaker: Annemarie Forrest

Click here to view recommendations and tools from the Informed Consent Project.

 

Poster: The Clinical Trials Transformation Initiative: Improving the Quality and Efficiency of Clinical Trials
Date & Time: Monday & Tuesday, May 16 – 17, 2016
Speakers: Pamela Tenaerts, Martin Landray, Christine Pierre, Ted Lystig, Annemarie Forrest

 

Presentation: Collaborating with Patient Advocacy Groups at the Design Stage of Your Clinical Trial: Why It Is So Important
Date & Time: Tuesday, May 17, 2016
Speaker: Bray Patrick-Lake

Click here to view recommendations and tools from the Patient Groups in Clinical Trials Project.

 

 

CTTI Recommendations for Data Monitoring Committees to be Unveiled at the Society for Clinical Trials (SCT) Annual

Data Monitoring Committees (DMCs) play a critical role in clinical trial conduct; however, the definition and role of a DMC are often misunderstood, even among stakeholders in the clinical trial enterprise. CTTI recommends that DMCs should be used when there is a need to periodically review the accumulating unmasked safety and efficacy data by treatment group, and advise the trial sponsor on whether to continue, modify, or terminate a trial based on benefit-risk assessment. Jane Perlmutter, patient advocate and team leader for the DMC Project, elaborates on this central theme of CTTI’s DMC recommendations:

“DMCs are something most clinical trial participants are unaware of. Yet, once a trial is approved by an IRB, DMCs are an important way to ensure that trials are proceeding in an orderly and ethical way and that the accumulating data do not suggest that the trial poses undue harm to patients.”

Given this important role of the DMC, it is imperative that they function optimally. The conduct of the DMC is largely dictated by a charter, which outlines the roles, responsibilities, and operational structure of the DMC, and should be agreed to by the sponsor and the DMC members prior to patient enrollment. Knowledge and experience of DMC members are other critical factors. New members would benefit greatly from apprenticeship or mentoring, as well as provision of case studies that illustrate challenging DMC scenarios.

The above-mentioned insights are just the beginning of a thorough examination on best practices for DMCs. CTTI’s full recommendations will be unveiled at this year’s Society for Clinical Trials (SCT) meeting. Join us for Invited Session 3 on Monday, May 16, where speakers Karim Calis, Raymond Bain, and Annemarie Forrest will reveal our recommendations. Dr. David DeMets, one of the thought leaders within the field of DMCs, will be the chair for this session. Following the unveiling, we hope you share Jane’s sentiments on the impact of our work:

“CTTI’s guidelines will help trial sponsors to follow best practices in regard to DMCs and also spur stakeholders to take measures to engage an adequate supply of diverse DMC members.”

CTTI Presents Innovations in Informed Consent at the AAHRPP Conference

In November 2015, CTTI released official recommendations for a new model of informed consent that places the focus back where it should be: the participant. This innovative approach to informed consent emphasizes the process, which should be an interactive, ongoing conversation between the participant and the research investigator or staff. Several tools are included within the recommendations, which were developed to assist researchers (at the site and sponsor) in implementing this strategy.

Today, two colleagues involved in CTTI’s Informed Consent Project, Michele Kennett and Ross McKinney, will present these recommendations at the 2016 Annual AAHRPP Conference. If you are attending this event, we invite you to attend this session and learn more about the project:

2016 Annual AAHRPP Conference
Conference Location: Longbeach, CA
Presentation Topic: Innovations in Informed Consent: the CTTI Project
Presentation Date & Time: Wednesday, April 20, 2016, from 10:30 AM – 11:45 AM
Speakers:

  • Ross McKinney, MD, MBA, Professor of Pediatrics, Duke University
  • Michele Kennett, JD, MSN, LLM, Director, Human Research Protections, University of Missouri

 

Don’t Miss CTTI Presentation at ACRP 2016

ACRP 2016

In the next week, the Association of Clinical Research Professionals (ACRP) will celebrate their 40th anniversary at the ACRP 2016 Meeting in Atlanta, GA. If you’re attending this conference, don’t miss the opportunity to learn about CTTI projects, directly from those working on them:

Topic: Improving Trial Recruitment and Informed Consent: Actionable Recommendations from CTTI
Date & Time: Monday, April 18, 2016, at 9:30 – 10:00 AM EST
Speakers:

  • Zachary Hallinan, Director, Patient Communication and Engagement Programs, CISCRP
  • Kelly McKee, Advisor, Clinical Innovation, Eli Lilly
  • Gerrit Hamre, Clinical Project Manager, CTTI

To view the complete program for this conference, click here.

FDA Calls For More Patient Population Diversity in Clinical Trials; CTTI is Ready to Help

Historically, many clinical trial populations have lacked diversity and comprised predominantly white men. Because it is important that trial populations are representative of the actual patients to be treated with the investigational product, the U.S. Food and Drug Administration (FDA) has made a call for increased diversity in clinical trial participants. An article authored by FDA Commissioner Robert Califf in FDA Voice summarizes the current issues with trial recruitment and how the lack of participant diversity affects the evaluation of investigational drugs. Data gathered by the FDA show that “some groups, especially ethnic and racial groups, aren’t always represented in clinical trials” and that “these data are critical because certain groups of patients may respond differently to therapies.” His point is well supported by examples of underrepresentation of certain demographics in cardiovascular and schizophrenia trials and the resulting consequences.

In response to the need for greater trial population diversity, the FDA has planned or initiated several activities to encourage greater inclusion: the Diverse Women in Clinical Trials initiative, collaboration with the National Library of Medicine, and engagement with patient advocacy groups. Many of these activities are aligned with the goals of CTTI projects. For example, the CTTI Recruitment Project is developing communication planning approaches to engage all eligible participants and providers, including minorities and underrepresented populations. Furthermore, based on the results of the Informed Consent Project, CTTI recommends that the informed consent process be customized to meet the needs of each individual, and that those obtaining consent are trained to be responsive to potential research participants unique needs and concerns; these measures may help less health-literate participants feel comfortable participating in clinical trials. Finally, CTTI’s Patient Groups and Clinical Trials Project has provided recommendations on best practices for effective engagement with patient groups, which can facilitate involvement of patients from all walks of life.

CTTI is in agreement with the FDA’s call to action and is well positioned to provide support.

CTTI Webinar: Case Studies on Expedited IND Safety Reporting

Are you confused about how best to comply with the FDA final rule on IND safety reporting? Would you like to hear more about how to handle common, yet challenging, safety reporting situations? Do you know someone who is interested?

CTTI invites you to participate in a webinar hosted by the IND Safety Advancement Project Team. This webinar is the first in a CTTI-hosted series designed to explore challenging safety reporting scenarios using case studies. We encourage you to share this invitation to others who may be interested in learning more about IND safety reporting.

Topic: Case Studies on Expedited IND Safety Reporting

Date: Thursday, April 21, 2016

Time: 12:00 p.m. – 1:00 p.m. EST

Presenters:

  • Patrick Archdeacon, Senior Clinical Advisor, Office of Medical Policy, Food and Drug Administration, Center for Drug Evaluation and Research
  • Annemarie Forrest, Associate Director of Projects, CTTI
  • Nina Stuccio, Head, Medical Safety Review, Global Clinical Safety & Pharmacovigilance, Merck, Inc.

WebEx Link
Meeting number: 735 340 171
Meeting password: ctti

After you connect to meeting website, please follow step-by-step instructions for connecting to the audio. If you prefer to connect to audio only, you can join by phone at:
1-855-244-8681 Call-in toll-free number (US/Canada)
1-650-479-3207 Call-in toll number (US/Canada)
Access code: 735 340 171

 

CTTI Work is Referenced in the FDA’s New Draft Guidance on Safety Assessment for IND Safety Reporting

The FDA issued a draft guidance in December 2015 on Safety Assessment for IND Safety Reporting. This guidance was developed as a follow-on to the 2010 guidance for Safety Reporting Requirements for INDs and BA/BE Studies and provides recommendations to help sponsors meet their obligations under 21 CFR 312.32. The FDA provides recommendations on the composition and role of a safety assessment committee, aggregate analyses for comparison of adverse event rates across treatment groups, planned unblinding of safety data, reporting thresholds for IND safety reporting, and development of a safety surveillance plan.

Page 4 of the guidance references CTTI work conducted by the IND Safety Project Team. (Recommendations developed during this project are available here.) The FDA addressed an observation that emerged during the IND Safety Project’s analysis of the evidence from surveys and multi-stakeholder expert meetings: sponsors have concerns about protecting trial integrity when reviewing serious adverse data from ongoing trials. To maintain trial integrity while assessing safety signals, the FDA recommends that sponsors use a safety assessment committee and develop a safety surveillance plan.

Comments on this draft guidance will be accepted until February 16, 2016.

CTTI continues to work in this area: the IND Safety Advancement Project is a follow-on to the IND Safety Project. This follow-on project seeks to promote full implementation of the FDA’s final rule by addressing particular challenges in oncology trials and generalizing solutions to other therapeutic areas.