Cancer Research Wales’ Head of Research, Dr Lee Campbell, delves into the challenges faced by the cancer clinical trial community over the past 12 months, but also sees hopeful opportunities on the horizon as we recover from the Covid-19 pandemic.
Today, 20th May 2021, marks international Clinical Trials Day in recognition of James Lind, the famous naval surgeon who conducted the first randomised clinical trial in 1747 to determine the merits of administering citrus fruits as a way of preventing scurvy in British seaman.
Why have clinical trials?
Although we have come a long way in the design of clinical trials since these iconic days in British history much work remains to be done if Wales is to continue to gain early benefit from the great scientific breakthroughs offered through clinical trials. There is significant evidence that a strong culture of research within a healthcare setting leads to improved outcomes for patients. In fact, embedding clinical trials into the heart of patient care has been designated as a top priority by the James Lind Alliance, and there is a great deal of interest in the best methods and practices to deliver this.
Clinical Trials and the Covid-19 Pandemic
Owing to the COVID-19 pandemic, clinical trials and recruitment of patients into research were understandably stopped overnight last year. However, as lockdowns have eased and life has begun to return to normal, many of these clinical trials are struggling to restart as healthcare providers work to deal with the large backlog of patients needing secondary care. Radiotherapy trials funded by Cancer Research Wales have also been affected.
The National Cancer Research Institute (the NCRI) has identified resuming clinical trials as a key priority during the recovery from the pandemic, with the concern that patients may otherwise miss out on the benefits of the latest developments in cancer research.
Clinical Trials in Wales
In Wales, the number of cancer patients recruited into clinical trials was already falling before the pandemic, reaching their lowest levels in a decade. There are a number of barriers that must be overcome to improve clinical trial recruitment and deliver on the promise that cutting-edge research provides.
Chief among these is a lack of resources, both financial and in personnel. In Welsh clinical trial services some notable cancer trials units have reached saturation, with successfully treated patients continuing their therapy long after the trial has ended. While this is to be celebrated and vindicates the success of cancer clinical trials, there is a knock-on effect. Namely, an inability to recruit and treat new patients as resources are already stretched to capacity. Investments in clinical trial facilities and staff will help to alleviate this bottleneck and ensure more patients can benefit from continued scientific advancement and new therapies.
Other barriers to the delivery of clinical trials in Wales revolve around a lack of integration between the Health Boards. Currently, ethical approval for research must be sought from each Health Board individually while access to patient records often falls under specific service contracts. These issues mean that conducting a clinical trial across Wales has become much more labour intensive and expensive than in other nations, unfortunately leading to Wales becoming an unattractive location for academic and industry trials alike. Ultimately, patients lose out from these barriers, which should be relatively simple to remove.
In the summer of 2020, two Senedd Cross Party Groups for Medical Research and Cancer reported into the state of medical research and cancer in Wales, with contributions from healthcare professionals, researchers and funding bodies including Cancer Research Wales. Clinical trials featured heavily in both reports.
In the near future, the sector will face a significant reduction in research funding from charities a result of the loss of income caused by measures to supress the pandemic. The Welsh Government will need to take a greater share of responsibility to ensure that research, and clinical trials in particular, have a bright future and are able to fully take advantage of the many benefits of being located or co-located in a small nation such as Wales.
Clinical trials offer Welsh patient’s early access to new treatment’s, and importantly hope, in a safe, controlled and friendly environment. Long may they continue to be an important part of service delivery across Wales.
You can read more about previous Clinical Trials Days on the Cancer Research Wales blog:
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