• by Les Luchter , 4 hours ago

Not a big surprise: Pharma industry clinical cancer trials favor the advancement of drug solutions over other treatment options.

That’s according to a study published Aug. 20 in the American Medical Association’s JAMA Oncology.

Meanwhile, those sponsored by such government entities as the National Institutes of Health (NIH) and the National Cancer Institute (NCI) are more likely to evaluate dose de-escalation, prevention screening, supportive care, and such non-drug interventions as surgery, transplants, and behavioral options. 

While both kinds of clinical trials were deemed necessary and complementary by the  study authors, drug industry-sponsored ones are rapidly increasing their lead over those from government.

Examining 11,681 U.S clinical cancer trials initiated between 2008 and 2024, the research found 90% of patient enrollments to be in industry-sponsored trials. This figure doubled between 2010 and 2020 -- and stood in stark contrast to 40 years ago, when most such research was supported by the NCI, the authors wrote.

Since the end of the time period studied, the Trump Administration has made further funding cuts to the NIH and NCI.

The increasing imbalance between federally and industry-backed trials “raises concerns that research questions lacking commercial incentives may go unanswered,” the authors write.

“The adverse consequences may also extend to industry,” they continue. “Between 2015 and 2024, among U.S. counties, those with NCI-funded trial sites were nine times more likely also to host industry-sponsored trials, suggesting that federally supported clinical trial infrastructure serves as a platform for industry-sponsored research.^“

On a positive note, while federally sponsored trials have historically been more likely to focus on therapies for rare cancers and children, “industry sponsorship of pediatric cancer trials has increased substantially and now accounts for more than twice the enrollment of pediatric patients compared with federal sponsors,” the authors wrote.

Additionally, “the distance between federal and industry sponsors on rare cancer trials has shrunk over the time period studied,” stated a press release from the SWOG Cancer Research Network, which is part of the NCI’s National Clinical Trials Network and Community Oncology Research Program

“Federally sponsored research brings much of the basic science discovery, trial infrastructure and early efficacy studies, while industry leads in late-stage determinative trials resulting in regulatory approvals,” explained study lead author Joseph M. Unger, PhD in the press release, 

The federal trials “may then test combinations of newly approved drugs with each other or with different treatment approaches such as surgery or radiation, extending therapeutic discovery,” added Unger, who works for both study co-funders: as health services researcher at SWOG and as a professor at Fred Hutch Cancer Center.