Despite the well-known difficulties with recruitment, design, interpretation and ethics in clinical trials of cancer drugs, the majority of oncologists and clinical research professionals in the US appear optimistic about the future of the field.

And one of the main reasons, it seems, is the current trend towards targeted therapies, according to a survey for cancer care specialist US Oncology.

Conducted by KJT Group, the survey asked 199 oncologists or haematologists and 100 clinical trial professionals across the US for their views on personalised medicine trends in cancer treatment and research, as well as the impact of regulatory policies and reimbursement on clinical trials. KJT Group also sought opinions on the quality of clinical research, the patient accrual process, and ways of reducing obstacles to patient participation.

Overall, 58% of the poll reported being optimistic about the future of clinical trials in the US, with 25% either ambivalent or unsure and only 17% feeling pessimistic about the future. Notably, 53% of the respondents thought that recruiting patients to clinical trials with targeted oncology therapies would be less difficult than for large-scale randomised trials with more traditional cytotoxic drugs.

The survey also highlighted the importance of policy initiatives that could move forward the personalised medicine agenda.

Prominent among these were industry collaboration on the development of personalised medicine (rated as ‘very effective’ – six or seven on a scale of seven – by 53% of respondents); government subsidisation of clinical trials for personalised medicine (54%); R&D tax credits for the biopharmaceutical industry to encourage the development of personalised medicine (50%); and national patient databases to match patients with appropriate clinical trials.

On the reimbursement front, 51% of respondents referred to mandatory health plan coverage of standard-of-care services as the single most important factor when in came to boosting patient participation in clinical trials. Cost/reimbursement alignment was cited as a ‘very important’ (rating six or seven out of seven) factor in oncologists’ and clinical trial professionals’ decisions to promote personalised medicine by 55% of respondents.

Regulatory red tape was blamed by 83% of respondents for the lengthy clinical trial approval process in oncology. Other culprits identified were inefficiency on the part of the organisation initiating the trial (51%), lack of funding (44%) and “excessive analysis” (29%).