ecancermedicalscience

Research

Timelines to initiate a phase III trial across the globe: a sub-analysis of the APHINITY trial

29 Apr 2022
Maria Alice Franzoi, Marion Procter, Chris Twelves, Noam Pondé, Daniel Eiger, Orianne Emond, Emma Clark, Damien Parlier, Sébastien Guillaume, Linda Reaby, Evandro de Azambuja, Jose Bines

Background: Geographic location and national income may influence access to innovation in healthcare. We aimed to study if geographical location and national income influenced the timelines to activate the global phase III APHINITY trial, evaluating adjuvant pertuzumab in patients with HER2-positive early breast cancer.

Methods: Time from regulatory authority (RA) submission to approval (RAA), time to Ethics Committee/Institutional Review Board (EC/IRB) approval, time from study approval by EC/IRB to first randomised patient and from first to last randomised patient were collected. Analyses were conducted grouping countries by geographical region or economic income classification.

Results: Forty-one countries (of 42) had data available regarding all relevant timelines. No statistical difference was observed between the time to RAA and geographical region (p = 0.47), although there was a trend to longer time to RAA in upper middle-income economies (p = 0.07). Except for time from first to last patient randomised, there was wide variation in timelines overall and within geographical regions and economic income groups.

Conclusions: Geographical location and income classification did not appear to be the major drivers influencing time for clinical trial activation. Wide variability in activation timelines within geographical regions and income groups exists and is worthy of further investigation.

Related Articles

Julia Downing, Eve Namisango, Stephen Connor, Patricia Batanda, Lisa Christine Irumba, Berna Basemera, Alfred Jatho, Sylvia Nakami, Harriet Nalubega, Antonia Kamate, Dianah Basirika, Joyce Zalwango, Mable Nammudu, Wedzerai Chiyoka, Francis Kayondo, David Byaruhanga, Eugene Rusanganwa, Helena Davis, Stephen Watiti, Babe Gaolebale, Lacey N Ahern, Lydia Thomas, Emmanuel Luyirika
Deevyashali Parekh, Vijay M Patil, Kavita Nawale, Vanita Noronha, Nandini Menon, Sucheta More, Supriya Goud, Srushti Jain, Vijayalakshmi Mathrudev, Zoya Peelay, Sachin Dhumal, Shweta Jogdhankar, Kumar Prabhash
Ana Teresa Vilares, Riccardo Ciabattoni, Teresa Margarida Cunha, Ana Félix
Maya M Hicks, Kenneth Chanda, Mulindi Mwanahamuntu, Monica B Jones, Anissa R Mattison, Krista S Pfaendler, Leeya F Pinder, Groesbeck P Parham, Michael L Hicks