For more than 50 years, most of what doctors know about which cancer treatments work and which ones don't has come out of a big federally funded network of far-flung academic researchers known obscurely as the Cooperative Group Program.
That program is now "at a breaking point," says Dr. John Mendelsohn of the M.D. Anderson Cancer Center in Houston. "The program urgently needs changes across the board."
Mendelsohn chairs a group of 17 experts convened by the National Institute of Medicine to diagnose the Cooperative Group's ills, and they found many.
The report they released today says lives will be lost and money wasted if the Cooperative Group isn't overhauled quickly.
For starters, the panel says, the program is starved for funds.The experts say that budget needs to double by 2015.
The current Cooperative Group budget is $250 million a year — less than three percent of the National Cancer Institute's annual budget — to do studies involving 25,000 cancer patients a year.
Part of the money would boost funding for academic researchers, who are underpaid for the time they spend on clinical trials, the IOM panel says. Academic institutions are uniquely suited to this work because they value the kind of basic (non-human) research and patient care the Cooperative Group needs.
Many of the questions studied by the Cooperative Group are not likely to be tackled by pharma or biotech companies, the IOM panel says. Commercial firms are mainly interested in studies that will get their drugs approved, not in research that compares, say, different combinations of drugs.
Patients often have disincentives to sign up for clinical trials too. Health insurers, including government programs, should pay for the clinical care they need when they're enrolled in a study, the IOM committee says.
The panel also says it takes too long — two years on average — for the Cooperative Group to design, approve and launch a study. By the time a trial gets underway, the questions it was designed to answer are often outdated. That does no service to cancer patients who volunteer for clinical trials, and it wastes money too.