Clinical trials The UK has fallen down the global rankings
for late-stage clinical research, dropping from second to sixth in Phase II trials and fourth to 10th in Phase III trials. Patient access to industry clinical trials on the National Institute for Health and Care Research Clinical Research Network (NIHR CRN) fell from 50,112 to 28,193 between 2017/18 and 2021/22 – a 44% drop. These stark findings are alarming for all of
us, not least because the report found that consistently slow and variable study set-up and recruitment timelines in the NHS are forcing some pharmaceutical companies to stage their trials in other countries. There is now a pressing need to find the most effective, efficient, and targeted solutions.
An opportunity for change In my opinion, supplementing NHS capacity with support from the independent sector is the key to success for some trials. It enables sponsors to have control over the speed of recruitment to the trial and it means hospitals and GP practices avoid unnecessary visitors when time and space are already at a premium. The ongoing debate about the future
approach and the current sense of urgency has stirred eminent voices. Dr. Lennard YW Lee is an associate professor at the University of Oxford, an NHS oncology consultant, and a National Clinical Advisor on Cancer Innovations and Research Studies. His expertise lies in delivering national studies and trials that push the boundaries of what is possible and breaking down silos to achieve quicker results. Addressing his social media followers last month, Dr. Lee pointed out that, during the pandemic, clinical trials that used to take decades, were completed within a year. Now, he says, we are left with a choice of returning to a pre-pandemic ‘business as usual’ or encouraging
Our Future Health mobile unit, Chorley, Lancashire new methods. “Do we continue to innovate, use new tools
like ‘pop-up’ decentralised models, digital tools and focus on timely delivery of research? This will be critically important as we start to scale up our national efforts for cancer vaccine trials, an area of research that is getting doctors, patients and charities very excited indeed.” Dr. Lee added: “I know what my patients,
doctors and researchers want. The question is, when the clinical trial review lands, will we allow our clinical trials infrastructure to decay back to 2019 levels or can we move it into the future? Will our next generation #cancervaccine trials be more patient focused, efficient and better than what we have now? The future of clinical trials, and the speed of transformative care to cancer patients, is in our hands.” There is strong evidence that taking trials
out of traditional healthcare settings attracts a more positive response from participants. It also enables hard-to-reach communities to have easier access to trials, giving studies better population representation and strengthening their data as a result. The GRAIL NHS-Galleri Trial, which is using EMS Healthcare mobile units to
reach 140,000 participants across the country, is one of the leading examples of this approach. It is the world’s largest trial of a revolutionary
new blood test that can detect more than 50 types of cancer before symptoms appear. Participants have been giving blood samples at mobile testing clinics parked in retail parks and other convenient community locations. The target of 140,000 was reached within 10 months and achieved a participant satisfaction rate of 97%, which was critical to ensure people came back 12 months later for their next test. We are currently on target to achieve an exceptionally high retention rate of 92%. The NHS-Galleri trial is being run by The
Cancer Research UK and King’s College London Cancer Prevention Trials Unit in partnership with the NHS and the biotechnology company, GRAIL. Sir Harpal Kumar, president of GRAIL Europe,
gave this assessment: “Using mobile clinics for this study is important for two reasons. The first is that we want to be able to access as many people as possible in the population. By using mobile clinics, we have a presence in locations that are easier for volunteers to get to. Hopefully, we can overcome the typical problem that studies face in ensuring a good representation of the population, by having the clinics in convenient places. “Secondly, we didn’t want to increase the
burden on the NHS. The mobile clinics give us an opportunity to undertake the study in all the ways we need to, without adding more pressure on the NHS.” Initial results of the study are expected this year and, if successful, the NHS in England plans to extend the rollout to a further one million people in 2024 and 2025.
NHS-Galleri clinical trial mobile unit 54
www.clinicalservicesjournal.com I June 2023
Looking to the future As always, collaboration remains the key to securing progress. EMS Healthcare is currently supporting ‘Our Future Health’, the UK’s largest health research programme, with mobile units
©EMS Healthcare
©EMS Healthcare
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