No time to waste—we need to start cancer clinical trials faster

Abstract

Cancer clinical trials in the UK are at a critical juncture. They face significant systemic pressures within the NHS and regulatory pathways that threaten efficiency and timeliness. Both commercial and non-commercial trials are vital for advancing cancer treatment and improving patient outcomes. However, non-commercial trials, which are key to tackling rare and hard-to-treat cancers and treatments with limited commercial interest (eg, radiotherapy and surgery), must not be left behind. Clinical trials have been instrumental in the substantial progress made in cancer care over the past 50 years. They have led to a doubling of cancer survival rates and groundbreaking diagnostics and treatments.1 The UK, with its world class research infrastructure and NHS, has been at the forefront of these advances. That position is, however, undermined by delays and inefficiencies in the current system that threaten to hinder this progress.23 The set-up of clinical trials in the UK is a disproportionately complex process involving multiple regulatory approvals, the setting up of contracts between sponsors and partners, and the need to work across numerous NHS sites. Cancer trials, in particular, often require specialised infrastructure such as radiology, pharmacy, and pathology. These challenges are compounded by constraints on resources within the NHS, leading to considerable delays in trial initiation.456 While both commercial and non-commercial trials are affected, the latter—often funded by charities and public institutions—recruit the majority of patients in the UK7 and therefore are the main route for patient access to trial treatments. Accelerating set-up times for these trials is critical. The importance of non-commercial trials cannot be overstated. They investigate …