CTTI Participates in PDUFA V Clinical Outcome Assessments Public Workshop

Today, CTTI’s Director of Stakeholder Engagement Bray Patrick-Lake joins colleagues at the FDA Clinical Outcome Assessments Public Workshop to discuss accomplishments, challenges, and ongoing efforts in the use of clinical outcome assessments (COAs). Additionally, they group will plan for the future of COA development and utilization in drug development programs, including how to incorporate the patient voice in drug development using well-defined and reliable patient-centered outcome measures. To view the meeting materials, including agenda and background documents, click here.

For a complete list of CTTI’s upcoming events, click here.

CTTI Director Involved in Early Stages of Precision Medicine, Participant Engagement Promises to be Central

When President Obama launched Precision Medicine on January 30, 2015, a great deal of excitement burgeoned around the potential to revolutionize our approach to disease prevention and treatment. Two months later, the foundation for the initiative is being laid and CTTI is proud to be involved in the heart of the action.

Yesterday, the NIH announced the creation of a team of experts to host public meetings and seek public input into the design of the initiative. This working group will help chart the course for the President’s Precision Medicine research network. We are thrilled that CTTI’s Director of Stakeholder Engagement Bray Patrick-Lake will serve as co-chair on this newly formed team, alongside Richard Lifton of Yale University School of Medicine and Kathy Hudson of the NIH.

One of the initial goals of the research network is to build a group of at least 1 million research participants who “will volunteer to share their biological, environmental, lifestyle and behavioral information and tissue samples with qualified researchers in a way that protects participant privacy” (NIH). While NIH Director Francis Collins realizes that this is an “audacious endeavor,” many are realizing the need to improve the clinical trials system so that the enterprise is ready and able to keep up with the demands of President Obama’s new program.

CTTI’s work to improve the quality and efficiency of clinical trials is critical to ensure that the promises of Precision Medicine are realized, and participant engagement will be key. Bray Patrick-Lake, who is a patient advocate herself working intensely on patient and stakeholder engagement at CTTI and Duke said, “Unleashing the power of participant engagement in design and operations of the Precision Medicine research activities and novel clinical trial design will allow us to realize the full potential of mobile technology and genomic science. Working in partnership across all sectors of research will finally allow us to make the quantum leap in treatment and prevention that patients have been waiting for.”

Updated AACT Database Now Available on the CTTI Website, New Features Included

CTTI’s State of Clinical Trials Project set out to facilitate the analyses of data in ClinicalTrials.gov, by creating the database for Aggregate Analysis of ClincalTrials.gov (AACT), a restructured and reformatted relational database developed using publicly available and downloadable data from ClinicalTrials.gov. Since the original AACT was created in 2010, we’ve continued to regularly issue updated versions of the database.

The latest version of the AACT Database is now available on the CTTI website, along with the supporting documents. This dataset reflects data downloaded from ClinicalTrials.gov in September 2014. To assist users with interpretation of the data, high level and comprehensive data dictionaries and a points to consider document are also located on the CTTI website. Previous versions of AACT are available as well.

We are pleased to announce that new features to assist usability accompany the most recent AACT Database. Please see the Points to Consider Document for more details. These features include:

  • An additional “readme” document is included in the pipe-delimited text files zip file for users who plan to work with the data extracts in the R statistical computing environment.
  • A target duration (e.g. 180 Days) variable is now included for records where the STUDY_TYPE=”Observational [Patient Registry]”.
  • New “Delayed Results” data elements are included in the pipe-delimited text files and SAS CPORT transport files. This includes a list of studies, provided by the National Library of Medicine, that had submitted a certification or extension request to the 12-month results reporting requirement before September 27, 2014, and the date of the first certification or extension request. For further details, refer to the “readme” documents within the zip files.

Since CTTI released the first AACT database, it has been utilized to answer many questions regarding the landscape of clinical trials. For a list of peer-reviewed publications that have assessed the state of trials within medical specialties, CLICK HERE.

CTTI Welcomes New Member Pulmonary Fibrosis Foundation

CTTI would like to welcome newest member Pulmonary Fibrosis Foundation. As a leading provider of education and support for the pulmonary fibrosis (PF) community, they represent one of many key stakeholders that CTTI engages to collaboratively improve the quality and efficiency of the clinical trials enterprise. Chief Executive Officer Daniel Rose, MD, will represent the Pulmonary Fibrosis Foundation on CTTI’s Steering Committee.

For more information about CTTI’s organizational structure, including the Steering Committee, CLICK HERE.

Clinical Trial Sponsors Fail to Report Results to Participants, Public

Despite legal and ethical mandates for disclosure, results from most clinical trials of medical products are not reported promptly on a registry specifically created to make results of human studies publicly available, according to Duke Medicine researchers.

Among all clinical trials of medical products, those funded by industry were the most likely to be publicly disclosed in a timely fashion, but even then, compliance was poor. Research funded by the National Institutes of Health and academic institutions lagged further, according to findings published by Duke Medicine researchers in the March 12, 2015, issue of The New England Journal of Medicine.

Study authors said the lack of transparency by industry, federal funders and academia has created a critical information gap about investigational drugs, devices and biologic therapies that not only hampers progress, but also violates obligations to patients.

“Patients who participate in clinical research have the expectation that the risk of participation will be offset by the creation of generalizable knowledge and the advancement of science, and that is achieved through the availability of clinical trial results,” said lead author Monique Anderson, M.D., cardiologist and researcher at the Duke Clinical Research Institute. “Sponsors who lead clinical trials have an ethical and legal obligation to publicly report their findings, whether the results are positive or negative.”

To read the press release in full, click here.

*Click here to view the the dataset used for this manuscript. (The first worksheet in this Excel file contains the description and data dictionary; the second worksheet contains the data for the 13,327 studies and all of the variables used in the analysis.)

Leadership Changes at CTTI

We are thrilled to announce that Mark McClellan, MD, PhD, has joined CTTI as chair of the executive committee. McClellan is a past FDA commissioner and administrator of the Centers for Medicare & Medicaid Services (CMS). He currently works at the Brookings Institution. He is familiar with CTTI’s mission and work given our respective efforts to help FDA on antibacterial drug development, approval pathways, active postmarket surveillance, and other projects. We are pleased to have someone with McClellan’s experience, leadership, and passion for improving clinical trials join our effort.

We are also delighted to share that John Alexander, MD, MHS, FACC, will join the executive committee representing Duke University. Alexander has already done great work as the Duke steering committee representative, and is excited to increase his involvement at the programmatic level. As a passionate clinical trialist who has spent time working with the PMDA and MHLW in Japan, Alexander will bring that additional international perspective as well.

Historically, as founding members of CTTI, Duke and FDA have named the co-chairs of the initiative, and those same individuals have served as co-chairs of EC. We are now separating these roles: McClellan will be the chair of the EC, and Alexander will join CDR Melissa Robb as co-chairs of the initiative. The three of them will work closely together, along with executive director Pamela Tenaerts, MD, MBA, and the executive committee, to provide strategic leadership for the organization.

Expert Meeting Summary Available: Thought Leaders Lay Foundation for Effective Engagement with Patient Groups

Key stakeholders in the clinical trials enterprise have declared a commitment to create a more effective model for engagement between research sponsors, investigators and patient groups, leading to better clinical trials; however, no guidelines for best practices currently exist. Actionable recommendations are needed, and CTTI is working to address this unmet need.

On January 21-22, 2015, CTTI convened a multi-stakeholder group of experts and thought leaders from across the clinical trials enterprise to address barriers to patient group engagement. Specifically, the meeting attendees set out to:

  • Define consensus principles of Patient Group engagement from the 3-way (Industry, Patient Group, and Academia) stakeholder perspectives using case studies of success and barriers
  • Share evidence and key findings from a multi-stakeholder assessment of Patient Group engagement in the Clinical Trial process
  • Gain understanding of the FDA Rules of Engagement and various Conflict of Interest (COI) issues
  • Solicit feedback on evidence to inform recommendations that can further enhance the value to industry, academia and patient groups of mutually beneficial partnerships that engage the patient groups as fully as possible in the complete spectrum of the clinical research enterprise
  • Solicit feedback on benchmarking, metrics, and value of patient engagement in clinical trials for research sponsors

In addition to providing the presentation materials from this expert meeting, we are pleased to share the summary as well. These materials describe the current landscape of patient engagement, and provide an evidence-based foundation for moving forward.

 

CLICK HERE TO VIEW THESE MEETING MATERIALS.

CDER Director Tips Hat to CTTI for Assisting with Reform of the Clinical Trial System

In a recent interview, the Director of the FDA’s Center for Drug Evaluation and Research (CDER), Dr. Janet Woodcock, was given the opportunity to share her vision for the center in 2015. When asked where she would most like to see advances in the realm of drug discovery, research, and development, Dr. Woodcock pointed to the need to reform the clinical trial system to reduce wastefulness. She cited CTTI’s role in analyzing and innovating different components of trial conduct and design; “I think we’ve made significant progress there,” stated Woodcock.

To read the transcript of the interview in full, click here.

Executive Director Shares Inside Perspective on CTTI’s Work in CenterWatch Profile

CenterWatch’s Insider Insights is a semi-monthly publication that features organizations in the clinical trials space. Recently, Staff Writer Ronald Rosenberg sat down with CTTI’s Executive Director Pamela Tenaerts to discuss CTTI’s work. Their conversation touched upon the evolution of CTTI’s mission, which now includes an emphasis on the implementation of recommendations to improve clinical trial quality and efficiency. They also discussed CTTI’s pioneering approach to enhancing the patient voice, as well as the recently unveiled recommendations for streamlining GCP training practices. To read the article in full, click here.

“One of our biggest successes is [the] forum we created, in which there is trust for open dialogue… This atmosphere allows us to have all the stakeholders in clinical trials involved in being part of the solutions.”
-Pamela Tenaerts, M.D.

CTTI Welcomes 2 New Patient Representatives to Steering Committee

CTTI is pleased to announce the two newest additions to our Steering Committee, Diane Cook and Barbara LeStage.

As individual patient/caregiver representatives, they will collaborate with other stakeholders as equal partners to ensure that their unique perspective is represented in CTTI’s Steering Committee activities. These activities include analyzing existing research impediments and recommending consensus-driven, actionable solutions that will lead to a more sustainable and effective clinical trial system.

Cook and LeStage will be joining Stephen Mikita and Cynthia Geoghegan as individual patient/caregiver representatives at CTTI. To view a complete list of the membership organizations, including patient groups, click here.

We are honored to have such high quality patient/caregiver representatives to advocate for the patient voice at CTTI. Below, you will find additional information on each of our newest members.

 

Diane Cook

Diane CookDiane Cook was diagnosed with Parkinson’s disease in 2008. She has participated in 10 clinical trials or research studies to date. Realizing the importance of the patient voice in clinical trials, Diane has gone on to partner with the research community to serve in roles such as co-principal investigator in hopes of developing higher quality, more efficient trials. Diane founded the Self-Efficacy Learning Forum (SELF) through which she has helped hundreds of recently diagnosed Parkinson’s patients increase their self-efficacy skills and behaviors to better manage their disease. She presented at the 2nd International Movement Disorders Congress in Sydney and served on the faculty of the 3rd World Parkinson’s Congress in Montreal. Her efforts to increase collaboration between the patient and research communities include the establishment of an annual Clinical Trial Research Forum in Denver, attracting hundred of patients and researchers, and a research study pairing local researchers and patients to identify opportunities and barriers to increased patient involvement in the research process. Diane serves as Patient Representative to the FDA, on the People with Parkinson’s Advisory Committee to the Parkinson’s Disease Foundation, as Colorado State Director for the Parkinson’s Action Network, as Advisory Committee Member of the University of Colorado Center for Movement Disorders and Neurorestoration.

 

Barbara LeStage

Barbara LeStageWhen Barbara was fifteen, her forty-one year old mother died of pancreatic cancer. In the 1970s her father was diagnosed with spindle cell carcinoma of the face requiring extensive surgery, radiation and plastic surgery. Barbara is a 19 year survivor of Stage 1 carcinoma of the breast. Her career as a cancer advocate began in 1975 when asked to volunteer for the American Cancer Society, eventually serving as Chair of the ACS Massachusetts Division Board and as a member the ACS National Board of Directors from 1988-1999. In 1993 Barbara’s focus began to shift to research advocacy. She served on three ACS national extramural research committees and the Council for Extramural Grants. She is past chair of the NCI Director’s Consumer Liaison Group (now the Council of Research Advocates) and a past member of NCI’s Central IRB, Advisory Committee to the Director, Informed Consent Template Update Working Group and Concise Informed Consent Document Planning Committee. She is currently serving as a member of NCI’s Clinical Imaging and Patient Advocate Steering committees and the Dana Farber/Harvard Cancer Center’s Breast Cancer Advocacy Group. Barbara chaired the Patient Advocacy Committee of the American College of Radiology Imaging Network (ACRIN) for seven years and was a member of protocol teams for two trials. She was a faculty member of the 2006 Clinical Trials Methodology Workshop conducted by the Radiological Society of North America. 2015 will be her fifth year as a faculty member of the ASCO/AACR Methods in Clinical Cancer Research Workshop.

Barbara received a B.S. from Denison University and a Master of Health Professions degree from Northeastern University’s Bouvé College of Pharmacy and Health Sciences. She is a graduate of the National Breast Cancer Coalition’s Project LEAD and the American Cancer Society’s Stakeholder Training. She twice attended the American Association for Cancer Research’s Scientist-Survivor program.