Redefining clinical oncology trials: How agile site networks are accelerating new cancer treatments
Redefining clinical oncology trials: How agile site networks are accelerating new cancer treatments
By Matt Cooper and Scott Palmese | Published: 2025-10-26 13:35:00 | Source: MedCity News
Multisite oncology clinical trials require a delicate balance between speed, precision, and adaptability. However, these factors are being magnified in the growing global studies of new personalized cancer treatments. Site networks are emerging as powerful tools to help sponsoring organizations strike the right balance.
Networks of sites can be defined as independent clinical research centers that work together as a team and collaborate as a single business entity. By enabling efficiencies such as master contracts, centralized budgeting, and master confidentiality agreements, these networks can reduce paperwork hassles, speed up startup times, and lower overall trial costs in the long run by lowering the cost per randomized participant.
However, while site networks can provide significant operational advantages, there are also significant risks. For example, over-embeddedness in large public networks may compromise the independence and local expertise that are vital to engaging principal investigators (PIs) and expanding patient access. Smaller private networks may enable faster and easier contracting, but they lack access to specific facilities and specialists, as well as the larger numbers of patients and higher patient throughput needed for rare and later-stage cancer trials.
Therefore, sponsoring organizations must be able to evaluate the value that any particular site network can provide for each study. Relationships, data and transparency must play important roles.
Here are four key characteristics that a sponsoring company should scrutinize to determine whether a site network is likely to meet the strategic objectives of its oncology studies:
1. Selective location relationships. A network that cultivates a genuine relationship and partnership with its sites – rather than a more transactional business relationship – can often speed up operations because of its in-depth knowledge of the site. For example, a deep understanding of a site’s potential will accelerate a feasibility study or pre-study site visit (PSSV). Instead of taking a week to gather the required information, the necessary details may already be on file and available via a single email. Thus, such relationships also make it easier for sponsors and client relationship managers to work.
Frequent use of the network typically results in more open and transparent communication between all parties, which is crucial. To assess how the network is strengthening its relationships with the site, ask about ongoing communication methods and feedback loops. Do hundreds of locations come together for a monthly or quarterly conference call? Or do small teams meet frequently to discuss current and upcoming studies at a deeper level of detail? How are sites publicly recognized and appreciated for their efforts? Ongoing communication before, during, and after studies helps ensure site engagement and the most enthusiastic participation in both current and future research.
In addition, review the network’s attempts to reduce site and patient burdens. Incorporating dedicated, oncology-savvy and reliable Clinical Research Associates (CRAs) into sites is one way to achieve efficiencies across multiple studies, for example. Regular site visits will also be used to understand and proactively address site study pressures – such as bottlenecks that often occur in oncology studies around pharmacy, medical imaging and laboratory services. With supportive and transparent relationships, sites are more likely to actively participate in the experiences they accept.
2. A strategically blended set of locations. The “correct” site networks depend greatly on the objectives of each study and will therefore vary from study to study. Although large academic institutions with leading researchers may be desirable sites—particularly for some rare tumor indications—they often come with slower set-up processes, and already overburden clinicians and staff. Conversely, smaller sites with less experience in oncology trials may be highly motivated and able to quickly enroll an untapped patient population. Geography also plays a role in drug access, costs, and patient diversity. The best networks typically include a strategic mix of sites that match the study protocol.
Again, site intelligence is an essential part of ensuring that a network’s site collection aligns with the sponsor’s study priorities. Sites should be able to accommodate the stage of research (i.e. early versus late studies) and type of tumor being examined. Is the site already running other experiments, and if so, are they integrated? For example, are patients who were excluded from another site study ideal candidates for your trial? It can be said that clinically high-performing sites are those that build a balanced study portfolio and provide treatment options to as many of their patients as possible.
Using scenario modeling, site-specific knowledge and data, sponsors and CRMs should work with the protocol to stress test different mixes of public and private, large and small sites across different geographies to optimize speed, cost and results.
3. Deep team experience. It is often helpful for an oncology study to include one or two leading clinical experts. However, senior researchers may be involved in multiple trials simultaneously. In studies involving community sites with more experience in chronic disease research, an outside expert may serve as principal investigator while the specialist takes care of the patient’s daily needs.
The goal, of course, is to find experienced research teams fully committed to the current study. Through strong network relationships, experienced principal investigators and other team members may be willing to provide insights to enhance protocol development.
Sponsors should also ask about the experience of the entire research team (not just the principal investigator), including research nurses and junior doctors. Have they conducted similar studies before? Do junior doctors know the signs/symptoms of cytokine release syndrome or other potential adverse events? Transparency is a must. Sites must be “accessible at any time” by email, telephone, etc., and access to key figures must be direct; Any gatekeepers should be considered a red flag.
4. Site-sensitive operational efficiencies. When evaluating the operational efficiencies of a site network, data should be paramount. Look for a track record of sites willing to share metrics obtained from previous studies, such as registration speed, percentage of data entered within 48 hours, and data lock speed.
Additionally, be sure to consider how operational efficiencies can ease site and patient burdens. For example, master contracts and CDAs can reduce paperwork for sites – especially during multiple or subsequent trials – as well as speed up timelines for sponsors. Reducing administrative work (including ongoing administration processes such as streamlining billing and payment procedures) and providing a single point of contact to facilitate communication helps ensure sites stay focused on their priority – their patients.
Grid alignment strength
Site networks can play a pivotal role in aligning sponsors, sites, and investigators toward common goals in oncology clinical trials, but they are not one-size-fits-all. Sponsors should carefully examine site networks to ensure that they will provide strategic value to each individual study.
Those networks that foster strong relationships with a diverse mix of sites may be better equipped to ensure that all parties work cohesively to navigate the complexities of new cancer treatments. By joining forces, these site networks can streamline operations, enhance study quality, and accelerate the delivery of transformative therapies to patients.
Photo: Warchi, Getty Images
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