Barriers and potential solutions to international collaboration in neuro-oncology clinical trials: Challenges from the Australian perspective

Benjamin Y Kong; Candace Carter; Anna K Nowak; Elizabeth Hovey; Zarnie Lwin; Neda Haghighi; Hui K Gan; Hao-Wen Sim; David S Ziegler; Kirston Barton; Jonathon Parkinson; Robyn Leonard; Mustafa Khasraw; Matthew Foote

doi:10.1111/ajco.13606

Barriers and potential solutions to international collaboration in neuro-oncology clinical trials: Challenges from the Australian perspective

Asia Pac J Clin Oncol. 2022 Jun;18(3):259-266. doi: 10.1111/ajco.13606. Epub 2021 Jun 24.

Authors

Benjamin Y Kong^{1

2

3}, Candace Carter^{1

2}, Anna K Nowak^{1

2

4}, Elizabeth Hovey^{1

2

5

6}, Zarnie Lwin^{1

7}, Neda Haghighi^{1

2

8}, Hui K Gan^{1

2

9

10

11

12}, Hao-Wen Sim^{1

2

13

14}, David S Ziegler^{1

15

16}, Kirston Barton^{1

2}, Jonathon Parkinson^{1

2

3}, Robyn Leonard^{1

2}, Mustafa Khasraw^{1

2

17}, Matthew Foote^{1

2

7

18}

Affiliations

¹ Cooperative Trials Group for Neuro-Oncology, National Health and Medical Research Council Clinical Trials Centre, Sydney, Australia.
² Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
³ Department of Medical Oncology, Royal North Shore Hospital, St Leonards, Australia.
⁴ Department of Medical Oncology, Sir Charles Gairdner Hospital, Perth, Australia.
⁵ Nelune Comprehensive Cancer Centre, Randwick, Australia.
⁶ Faculty of Medicine, University of New South Wales, Sydney, Australia.
⁷ Royal Brisbane and Women's Hospital, Princess Alexandra Hospital, Brisbane, Australia.
⁸ Department of Radiation Oncology, Peter MacCallum Cancer Centre, Parkville, Australia.
⁹ Department of Medical Oncology, Austin Hospital, Melbourne, Australia.
¹⁰ Cancer Therapies and Biology Group, Centre of Research Excellence in Brain Tumours, Olivia Newton-John Cancer Wellness and Research Centre, Austin Hospital, Heidelberg, Melbourne, Australia.
¹¹ La Trobe University School of Cancer Medicine, Heidelberg, Victoria, Australia.
¹² Department of Medicine, University of Melbourne, Heidelberg, Victoria, Australia.
¹³ Kinghorn Cancer Centre, Darlinghurst, Australia; St Vincent's Clinical School, University of New South Wales, Sydney, Australia.
¹⁴ Chris O'Brien Lifehouse, Sydney, New South Wales, Australia.
¹⁵ Children's Cancer Institute, University of New South Wales, Australia and Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia.
¹⁶ School of Women's and Children's Health, University of New South Wales, Sydney, Australia.
¹⁷ Preston Robert Tisch Brain Tumor Center, Department of Neurosurgery, Duke University, Durham, North Carolina, USA.
¹⁸ School of Medicine, University of Queensland, Brisbane, Australia.

Abstract

Aim: The neuro-oncology community in Australia is well positioned to collaborate internationally, with a motivated trials group, strong regulatory bodies and an attractive fiscal environment. We sought to identify gaps in the Australian neuro-oncology clinical trials landscape and describe strategies to increase international trial access in Australia.

Methods: We searched clinical trial registries to identify active adult primary brain cancer trials. We compared the participation rate and phase of these trials between tumour types and countries. A survey was distributed to the Cooperative Trials Group for Neuro-Oncology membership to identify barriers and solutions to effective international collaboration.

Results: Globally, 307 trials for adult primary brain cancers were identified. These included 50% pharmaceutical agents, 18% cellular therapies and 9% radiation therapy. Twelve adult primary brain cancer trials were actively recruiting in Australia at the time the survey was sent out. There were more early phase brain cancer trials (34%) compared with colorectal and breast cancer (21% and 24%, respectively). In Australia, 92% of brain cancer trials were involving pharmaceutical agents. The most commonly cited barrier was lack of funding for international trials (86%) and insufficient research time (75%). High ranking solutions included increasing the availability of funding for international trials and creating opportunities to develop personal relationships with collaborators. Accreditation of clinical research key performance indicators into practice (88%) and hospital accreditation (73%) also ranked highly.

Conclusions: Participation in international research in Australia could be improved by embedding clinical research targets into institutional funding, provision of funding for early phase studies and streamlining mutual ethics schemes.

Keywords: clinical trials; ethics; funding; international cooperation; neuro-oncology.

MeSH terms

Adult
Australia
Brain Neoplasms* / therapy
Humans
Pharmaceutical Preparations
Surveys and Questionnaires

Substances

Pharmaceutical Preparations