Cancer Clinical Trials in NSW 2004-2006

Program evaluation
01 May 2008
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It is critical for long-term improvements in cancer outcomes that a high level of trial participation is achieved. Higher participation will mean that trial recruitment targets are met sooner, leading to a faster attainment of results and a shorter time to translate promising therapies into better routine clinical practice.

There is considerable evidence that improved practices through clinical trial results have substantially reduced cancer mortality.

This review of cancer clinical trials in NSW captured around 75% of the State's cancer trial activity. It revealed that there were 341 active trials during the period January 2004-December 2006, 4,381 patients were enrolled on trials in the three-year period and at the end of 2006, 5,290 patients were active on trials. In 2006 around 5.3% of newly diagnosed cancer patients were enrolled in clinical trials.

There was an increase of 31% in the number of active trials and 94% in enrolments to trials from 2004 to 2006. The clinical grouping with the most active trials was breast cancer, but melanoma had more enrolments in trials during this period. Most trials were multi-centred, around 60% were randomised controlled trials and 70% of enrolments were to investigator initiated or co-operative group trials.

Analysis of the number and types of trials open and new enrolments onto trials, compared with cancer incidence and mortality, provides insight into which patients are being offered trials and where more trials could be done for high-volume cancers. Correlation to the State's cancer mortality with trials available and enrolments to trials will assist future planning to promote more trials in clinical areas where improved survival through treatment advances is most needed. While more trials should be encouraged in all cancers, additional trials are particularly needed in respiratory cancers, urogenital cancers, upper gastrointestinal cancers, brain cancers, cancers of unknown primary site, bowel cancer and head and neck cancers.

A review of Human Research Ethics Committee (HREC) submissions demonstrated the high degree of duplication in administrative effort that occurred in 2004-2005, with 44% of cancer clinical trial submissions relating to trials that had already been submitted to an HREC elsewhere in NSW. The median time for approval of trials by an ethics committee was 60 days, with only 20% approved on first application, but only 1% of applications were ultimately rejected.

This review identified a high and increasing level of activity in cancer clinical trials in NSW. It highlights specific types of cancers where more trials are needed.

The NSW Cancer Trials Network aims to increase the quality and quantity of trials available to cancer patients and thus increase patient enrolment to clinical trials in NSW. This will be achieved by collaboration and partnerships within Area Health Service Networks. The NSW Cancer Trials Network provides a strategic, statewide approach to cancer clinical trials in NSW and will work the NSW Oncology Groups to encourage a high level of clinical trial activity in all clinical groupings.

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