Initiative to Speed Clinical Trial Negotiations Moves Forward
The U.S. Department of Justice (DoJ) has cleared the way for NCI and the CEO Roundtable on Cancer to move ahead with an effort to speed clinical trial contract negotiations by issuing a "business review letter" about the high-priority project.
The communication from the DoJ's Antitrust Division was requested by the CEO Roundtable to ensure there were no antitrust concerns related to the organization's ongoing efforts with NCI to develop "model language" for use in the contract agreements that govern clinical trials.
"The Department has no present intention of challenging the proposal to develop and publicize model clauses for use in clinical trial agreements," Assistant Attorney General Thomas O. Barnett explained in the letter.
"Although there is still work to be done, the DoJ's response ensures we can continue forward with this effort to streamline the negotiation process and expedite the performance of clinical trials," said NCI Director Dr. John E. Niederhuber. "This entire effort is another example of NCI's ability to be an honest broker, bringing the necessary parties together to facilitate the collaboration and partnerships needed to tackle some of the most profound challenges in conducting clinical trials."
Developing model language for clinical trials contracts was identified as a top priority by NCI's Clinical Trials Working Group in its 2005 report, and by private sector participants in the Roundtable's Life Sciences Consortium, which includes some of the country's largest pharmaceutical and medical device companies.
Representatives from the Life Sciences Consortium and a number of NCI-designated Cancer Centers and Cooperative Groups have participated in the model language effort. The process involved a review of 78 clinical trials agreements, some of which were contract templates, but most of which were redacted copies of actual contracts. From that review, stipulations or clauses in seven key areas (see sidebar) were found that routinely bogged down negotiations. Even so, nearly two-thirds of the time the final contract language in those areas was essentially identical.
"Anything that can codify potential contract language and speed the negotiations is of significant value," said Dr. Shelley Earp, director of the Lineberger Comprehensive Cancer Center at the University of North Carolina, who has been involved in the model language initiative. "There are always going to be specifics from trial to trial that differ, but if we can start with these generic endpoints, hopefully we can save a lot of time."
Dr. James Doroshow, director of NCI's Division of Cancer Treatment and Diagnosis, estimates that it could cut negotiation times by up to 3 months. "In some cases, that sort of time savings can make or break a trial," says Dr. Earp. "The longer you delay the launch of a trial, the more likely it is to fail," he says.
"Our research demonstrates that the length of time required to open a trial has a dramatic negative impact on eventual accrual to the study," Dr. Dilts says. "So these templates will not only affect the ability to launch trials, but also their eventual success."
The response thus far, according to Dr. Doroshow, has been very encouraging.
"I have had input from several companies that are very interested in starting to use this language," he says. "However, only time will tell how heavily it will actually be used."
The next steps, says Dr. Sheila Prindiville, director of NCI's Coordinating Center for Clinical Trials and one of the leaders of this effort, will be to gather more input from all of the NCI-designated Cancer Centers, Cooperative Groups, and their affiliated universities. The updated language and further information on this project will be posted publicly on NCI's Cancer Centers Web site.