how to open a clinical trial in ireland - cancer trials...dr roshni kalachand, mbbch, mrcpi ......

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How to open a clinical trial in Ireland Dr Roshni Kalachand, MBBCh, MRCPI

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Page 1: How to open a clinical trial in Ireland - Cancer Trials...Dr Roshni Kalachand, MBBCh, MRCPI ... Taking the plunge Challenges Unexpected challenges Engaging with CTI Tips USA 2014 Ireland

How to open a clinical trial in Ireland

Dr Roshni Kalachand, MBBCh, MRCPI

Page 2: How to open a clinical trial in Ireland - Cancer Trials...Dr Roshni Kalachand, MBBCh, MRCPI ... Taking the plunge Challenges Unexpected challenges Engaging with CTI Tips USA 2014 Ireland

Unmet clinical need…

Having an ideaTaking the

plungeChallenges

Unexpected challenges

Engaging with CTI

Tips

USA 2014 Ireland 2014 - 2016

Page 3: How to open a clinical trial in Ireland - Cancer Trials...Dr Roshni Kalachand, MBBCh, MRCPI ... Taking the plunge Challenges Unexpected challenges Engaging with CTI Tips USA 2014 Ireland

NetworkLinks with industry/scientists

TimeWorking in a

laboratory research setting

ResourcesResearch mentor also CTI vice clinical lead

Having an ideaTaking the

plungeChallenges

Unexpected challenges

Engaging with CTI

Tips

Unmet clinical need … meets fortuitous circumstances

Page 4: How to open a clinical trial in Ireland - Cancer Trials...Dr Roshni Kalachand, MBBCh, MRCPI ... Taking the plunge Challenges Unexpected challenges Engaging with CTI Tips USA 2014 Ireland

Initial steps: involve stakeholders into trial design

Having an ideaTaking the

plungeChallenges

Unexpected challenges

Engaging with CTI

Tips

Draft design v1.0

• Key rationale, aims, endpoints

Gauge interest

• Informal enquiries

Brainstorming meeting

• Key stakeholders

DRAFT DESIGN v2.0

Page 5: How to open a clinical trial in Ireland - Cancer Trials...Dr Roshni Kalachand, MBBCh, MRCPI ... Taking the plunge Challenges Unexpected challenges Engaging with CTI Tips USA 2014 Ireland

First contacts with Cancer Trials Ireland

Having an ideaTaking the

plungeChallenges

Unexpected challenges

Engaging with CTI

Tips

Study proposal at DSSG

International peer review

Protocol development and writing

Costings and funding

Page 6: How to open a clinical trial in Ireland - Cancer Trials...Dr Roshni Kalachand, MBBCh, MRCPI ... Taking the plunge Challenges Unexpected challenges Engaging with CTI Tips USA 2014 Ireland
Page 7: How to open a clinical trial in Ireland - Cancer Trials...Dr Roshni Kalachand, MBBCh, MRCPI ... Taking the plunge Challenges Unexpected challenges Engaging with CTI Tips USA 2014 Ireland
Page 8: How to open a clinical trial in Ireland - Cancer Trials...Dr Roshni Kalachand, MBBCh, MRCPI ... Taking the plunge Challenges Unexpected challenges Engaging with CTI Tips USA 2014 Ireland

Study proposal at DSSG

International peer review

Protocol development and writing

Costings and funding

First contact with Cancer Trials Ireland

Having an ideaTaking the

plungeChallenges

Unexpected challenges

Engaging with CTI

Tips

Page 9: How to open a clinical trial in Ireland - Cancer Trials...Dr Roshni Kalachand, MBBCh, MRCPI ... Taking the plunge Challenges Unexpected challenges Engaging with CTI Tips USA 2014 Ireland

Finalising the study design

Having an ideaTaking the

plungeChallenges

Unexpected challenges

Engaging with CTI

Tips

Funded

tBRCA tests

fell through

tBRCA

in SJH

Beaum

labs?

Develop and coordinate testing

pathway between

SJH/Beaumont/Crumlin

Germline

testing

outsourced

Full funding

not secured

O N E Y E A R

Page 10: How to open a clinical trial in Ireland - Cancer Trials...Dr Roshni Kalachand, MBBCh, MRCPI ... Taking the plunge Challenges Unexpected challenges Engaging with CTI Tips USA 2014 Ireland

Timeline.. longer than anticipated

Having an ideaTaking the

plungeChallenges

Unexpected challenges

Engaging with CTI

Tips

International peer review

Amendments following peer

reviewCosting and devising a

budget

Approval at SMG

Site selection

Feasibility questionnaires

Funding secured

Contracts reviewed and signed Ethics

submissions

Ethics amendments

Ethics approval

Sites initiation

First patient

enrolled ☺

Dec 2016

March 2017

June 2017

Trial design (2017) and protocol/PIL writing (2018)

Jan2018

April2018

June2018

November2018

June2018

October2018

October2018

January2019

March2019

April2018

Finalising other documents(CRFs, questionnaires)

Page 11: How to open a clinical trial in Ireland - Cancer Trials...Dr Roshni Kalachand, MBBCh, MRCPI ... Taking the plunge Challenges Unexpected challenges Engaging with CTI Tips USA 2014 Ireland

Securing funding

Having an ideaTaking the

plungeChallenges

Unexpected challenges

Engaging with CTI

Tips

Charities

Grants

Pharma

‘ESR’

Page 12: How to open a clinical trial in Ireland - Cancer Trials...Dr Roshni Kalachand, MBBCh, MRCPI ... Taking the plunge Challenges Unexpected challenges Engaging with CTI Tips USA 2014 Ireland

Securing funding

Having an ideaTaking the

plungeChallenges

Unexpected challenges

Engaging with CTI

Tips

Charities

Grants

Pharma

‘ESR’

6 months for approval from global

3 months for feedback on ESR

3 months for ESR to be approved

3 months to submit protocol

2 months to approve protocol

4 months to sign contracts

21 months

3-9 months for approval from board

0-3 months forfunding agreement

Page 13: How to open a clinical trial in Ireland - Cancer Trials...Dr Roshni Kalachand, MBBCh, MRCPI ... Taking the plunge Challenges Unexpected challenges Engaging with CTI Tips USA 2014 Ireland

Essential facilitator and support system

Having an ideaTaking the

plungeChallenges

Unexpected challenges

Engaging with CTI

Tips

Protocol and PIL template

Protocol dvlpmt

Budget

Costings

Stats

support

Ethics submis-

sions

Study initiation

Page 14: How to open a clinical trial in Ireland - Cancer Trials...Dr Roshni Kalachand, MBBCh, MRCPI ... Taking the plunge Challenges Unexpected challenges Engaging with CTI Tips USA 2014 Ireland

Regular communication and patience

Having an ideaTaking the

plungeChallenges

Unexpected challenges

Engaging with CTI

Tips

Me in the lab Orla and Anne-Marie at CTI

Page 15: How to open a clinical trial in Ireland - Cancer Trials...Dr Roshni Kalachand, MBBCh, MRCPI ... Taking the plunge Challenges Unexpected challenges Engaging with CTI Tips USA 2014 Ireland

Tips and treats

Having an ideaTaking the

plungeChallenges

Unexpected challenges

Engaging with CTI

Tips

• Mentor/supervisor– Principle investigator training programme?

• Spend time upfront thinking through and designing a thorough protocol– Networking

– Brainstorming

– Ultimately time saving

• Explore all funding options (pharma, grants, charities) upfront

• Early involvement with appropriate DSSG in CTI

• Regular communication with CTI– From study design to initiation

Page 16: How to open a clinical trial in Ireland - Cancer Trials...Dr Roshni Kalachand, MBBCh, MRCPI ... Taking the plunge Challenges Unexpected challenges Engaging with CTI Tips USA 2014 Ireland

Acknowledgements

Clinicians

Prof Bryan Hennessy

Dr Dearbhaile O’Donnell

Prof David Gallagher

Prof Andrew Greene

Dr Lisa Bradley

Dr Brendan Doyle

Prof Stephen Finn

Robert Cummins

Cathal O’Brien

Trudi McDevitt

Shirley McQuaid

Sharon O’Toole

Site PIs, subIs and CTU staff

Cancer Trials Ireland

Dr Orla Casey

Dr Anne-Marie Byrne

Dr Verena Murphy

Dr Imelda Parker

Gynaecology DSSG members

Funding bodies

Astra Zeneca

Emer Casey Foundation

Ovacare