What is the Current State of Remote Monitoring in Oncology Clinical Trials?

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A recent survey study published on JAMA Network Open sought to evaluate the current state and future aspirations for the use of remote technologies in oncology trials. The study authors surveyed eight biopharmaceutical companies, representing 33% of the oncology marketplace by 2021 revenues, to identify trends.¹

“Less than 5% of patients with cancer enroll in a clinical trial, partly due to financial and logistic burdens, especially among underserved populations. The COVID-19 pandemic marked a substantial shift in the adoption of decentralized trial operations by pharmaceutical companies,” the study authors wrote. “[The objective of the study was] to assess the current global state of adoption of decentralized trial technologies, understand factors that may be driving or preventing adoption, and highlight aspirations and direction for industry to enable more patient-centric trials.”

The survey sent to the biopharma companies measured (1) outcomes of different remote monitoring and data collection technologies on patient centricity, (2) adoption of these technologies in oncology and all therapeutic areas, and (3) barriers and facilitators to adoption using descriptive statistics. It was developed by the Bloomberg New Economy International Cancer Coalition, composed of patient advocacy, industry, government regulator, and academic medical center representatives.

All eight biopharma companies in the coalition completed the survey. According to the results, across nearly all areas of technology, oncology trials were lagging in adoption compared to other therapeutic areas. Electronic diaries and electronic clinical outcome assessments (eCOAs) are the most used technology with a mean (SD) of 56% (19%) adoption for all trials, but just 51% (29%) for oncology trials.

The difference between current and aspired adoption looking forward was large, with survey respondents expecting a 40% or greater absolute adoption increase in eight of the 11 technologies surveyed. Digitally enabled recruitment, local imaging capabilities, and local physician networks were identified as areas of focus for improving patient centricity in the long-term future.

“The results showed that many of the identified remote monitoring and data collection technologies, such as digital enrollment, are already being adopted across clinical trials,” the authors wrote. “Yet adoption of these innovations is lagging in oncology, despite the great unmet need given the relative lack of clinical trial availability in local community settings.”

According to the authors, the survey used in this study stands as the first attempt by a broad coalition of stakeholders with a vested interest in advancing patient-centric international cancer trials to set an aspiration for remote monitoring and data collection.

There were some limitations to the study identified by the authors. As previously mentioned, the coalition represented 33% of the marketplace by 2021 revenue. The findings may be limited by the companies’ membership in the coalition at the time of survey administration, which would not be entirely representative of the greater global biopharma industry.

“The findings suggest that investment may be required across the drug development ecosystem in both technology access and collaborative research infrastructure to equip stakeholders with the capabilities to adopt decentralized technologies in some of the most complex and historically demanding trials,” the study authors concluded. “Moreover, for these advances to be successful, solutions are needed to reduce bureaucratic workload for site staff and investigators and not introduce new administrative hardships.”

Reference

1. Daly B, Brawley OW, Gospodarowicz MK, et al. Remote Monitoring and Data Collection for Decentralized Clinical Trials. JAMA Netw Open. 2024;7(4):e246228. doi:10.1001/jamanetworkopen.2024.6228