National Cancer Institute
National Cancer Institute U.S. National Institutes of Health

Operational Efficiency Initiatives

Improving operational efficiency is essential for the cancer clinical trials system to fulfill its promise to deliver new treatments to patients more quickly. There are two critical areas in which operational efficiency could be enhanced. The first is to increase the rate of patient accrual so that trials can be completed in a more timely fashion. The second is to identify and reduce institutional barriers that prolong the time from concept approval to opening of patient accrual at sites.

Opportunities for increasing the rate of patient accrual include aligning NCI funding more closely with the actual cost of conducting a trial; creating incentives for high accruing, cost-efficient sites; educating patients and the public about the benefits of clinical trials; and improving access of minority populations to clinical trials. Reducing the time required to conduct clinical trials requires a systematic analysis of institutional and regulatory obstacles to trial initiation and execution.

For full details on the initiatives, see the CTWG Report (PDF - 366KB).

The CTWG Operational Efficiency Initiatives

Initiative 1: Restructure the funding model for phase III efficacy trials to create incentives for more rapid rates of patient accrual.

Initiative 2: Identify the institutional barriers that prolong the time from concept approval to the accrual of the first patient, and develop solutions for overcoming these barriers.

Initiative 3: Promote patient and public awareness and understanding of clinical trials.

Initiative 4: Expand current outreach programs to increase the recruitment of minority populations to cancer clinical trials.

Initiative 5: Develop approaches for enhancing adoption of centralized Institutional Review Board processes.

Operational Efficiency Initiatives-Key Accomplishments

Since 2006, administrative supplements have been provided to selected grantees in these programs to increase funding for recruitment of minority and medically underserved patients to NCI clinical trials. Each year, proposals were solicited through NCI Program Staff for requests for administrative supplements to established programs from eligible grantees. In 2008, nine continuation supplements, totaling $830,000, and 4 new supplements at $399,000 were awarded.