Complying with the European Clinical Trials directive while surviving the administrative pressure: An alternative approach to toxicity registration in a cancer trial
2014 (English)In: European Journal of Cancer, ISSN 0959-8049, E-ISSN 1879-0852, Vol. 50, no 2, 251-259 p.Article in journal (Refereed) Published
The European Clinical Trials Directive of 2004 has increased the amount of paper work and reduced the number of initiated clinical trials. Particularly multinational trials have been delayed. To meet this challenge we developed a novel, simplified, fast and easy strategy for on-line toxicity registration for patients treated according to the Nordic/Baltic acute lymphoblastic leukaemia protocol, NOPHO ALL 2008, for children and young adults, including three randomisations. We used a risk-assessment based approach, avoiding reporting of expected adverse events and instead concentrating on 20 well-known serious, but rarer events with focus on changes in therapy introduced in the treatment protocol. This toxicity registration strategy was approved by the relevant regulatory authorities in all seven countries involved, as compliant within the EU directive of 2004. The centre compliance to registration was excellent with 98.9% of all patients being registered within 5 weeks from the requested quarterly registration. Currently, four toxicities (thrombosis, fungal infections, pancreatitis and allergic reactions) have been chosen for further detailed exploration due to the cumulative fraction of patients with positive registrations exceeding 5%. This toxicity registration offers real-time toxicity profiles of the total study cohort and provides early warnings of specific toxicities that require further investigation.
Place, publisher, year, edition, pages
2014. Vol. 50, no 2, 251-259 p.
Acute lymphoblastic leukaemia, Clinical trial, Chemotherapy, Children, Toxicity, Registration
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:uu:diva-218959DOI: 10.1016/j.ejca.2013.09.027ISI: 000329986500001OAI: oai:DiVA.org:uu-218959DiVA: diva2:698184