PIPELINEs: Creating Comparable Clinical Knowledge Efficiently by Linking Trial Platforms

• Published in: Clinical pharmacology and therapeutics 2016-12, Vol.100 (6), p.713-729
• Main Authors: Trusheim, MR, Shrier, AA, Antonijevic, Z, Beckman, RA, Campbell, RK, Chen, C, Flaherty, KT, Loewy, J, Lacombe, D, Madhavan, S, Selker, HP, Esserman, LJ
• Format: Article
• Language: English
• Subjects: Clinical Trials as Topic - economics; Clinical Trials as Topic - methods; Clinical Trials as Topic - organization & administration; Cooperative Behavior; Endpoint Determination; Humans; Patient Selection; Reimbursement Mechanisms; Research Design; State of the Art; Time Factors; Translational Research, Biomedical - organization & administration
• ISSN: 0009-9236; 1532-6535
• DOI: 10.1002/cpt.514

Adaptive, seamless, multisponsor, multitherapy clinical trial designs executed as large scale platforms, could create superior evidence more efficiently than single‐sponsor, single‐drug trials. These trial PIPELINEs also could diminish barriers to trial participation, increase the representation of real‐world populations, and create systematic evidence development for learning throughout a therapeutic life cycle, to continually refine its use. Comparable evidence could arise from multiarm design, shared comparator arms, and standardized endpoints—aiding sponsors in demonstrating the distinct value of their innovative medicines; facilitating providers and patients in selecting the most appropriate treatments; assisting regulators in efficacy and safety determinations; helping payers make coverage and reimbursement decisions; and spurring scientists with translational insights. Reduced trial times and costs could enable more indications, reduced development cycle times, and improved system financial sustainability. Challenges to overcome range from statistical to operational to collaborative governance and data exchange.