4.7 Review

The Future of Clinical Trial Design in Oncology

Journal

CANCER DISCOVERY
Volume 11, Issue 4, Pages 822-837

Publisher

AMER ASSOC CANCER RESEARCH
DOI: 10.1158/2159-8290.CD-20-1301

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Funding

  1. BMO Financial Group Chair in Precision Cancer Genomics [CA186644]

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Clinical trials have evolved from traditional cytotoxic chemotherapy studies to biomarker-driven evaluations, aiming to provide safer and more effective treatments for patients. The future of cancer clinical trials will require a framework that efficiently transforms scientific discoveries into clinical applications, offering personalized treatment strategies and contributing to global knowledge and collective learning through collaboration among all stakeholders.
Clinical trials represent a fulcrum for oncology drug discovery and development to bring safe and effective medicines to patients in a timely manner. Clinical trials have shifted from traditional studies evaluating cytotoxic chemotherapy in largely histology-based populations to become adaptively designed and biomarker-driven evaluations of molecularly targeted agents and immune therapies in selected patient subsets. This review will discuss the scientific, methodological, practical, and patient-focused considerations to transform clinical trials. A call to action is proposed to establish the framework for next-generation clinical trials that strikes an optimal balance of operational efficiency, scientific impact, and value to patients. Significance: The future of cancer clinical trials requires a framework that can efficiently transform scientific discoveries to clinical utility through applications of innovative technologies and dynamic design methodologies. Next-generation clinical trials will offer individualized strategies which ultimately contribute to globalized knowledge and collective learning, through the joint efforts of all key stakeholders including investigators and patients.

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