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Prof D A Cameron NCRN Coordinating Centre, Leeds

NCRN - can we mature once we have stopped growing?. Prof D A Cameron NCRN Coordinating Centre, Leeds. Genesis. In the beginning there was darkness On the first day the Lord created the NCRN And the Lord saw that it was good

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Prof D A Cameron NCRN Coordinating Centre, Leeds

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  1. NCRN - can we mature once we have stopped growing? Prof D A Cameron NCRN Coordinating Centre, Leeds

  2. Genesis In the beginning there was darkness On the first day the Lord created the NCRN And the Lord saw that it was good On the second day the Good Lord created more TCRNs .... MHRN, Dendron, MCRN, stroke, PCRN, DRN And the Lord saw that they were all good So in the rest of the chaos they created the NIHR and CLRN…………….

  3. Overall accrual 2006/2007 ~50% ~25%

  4. 7.5% Overall accrual by Incidence Other CSGs……

  5. 7.5% Overall accrual by Incidence

  6. NIHR portfolio Active funding streams CRUK HTA Other charities Other NIHR funding routes Number of studies

  7. Volume of accrual

  8. What have we grown into? • Comprehensive coverage of UK • Tripled accrual to cancer studies • Highest per capita accrual in the world • Broad portfolio • Treatment, screening, genetics, follow-up • High accrual in a few cancers • Modest accrual in most cancers

  9. Maturity Maturity is the art of living in peace with that which we cannot change, the courage to change that which should be changed -- and the wisdom to know the difference.

  10. NIHR NCRN & UK partners • Scottish Cancer Research Network (SCRN) • North of Scotland Cancer Research Network • West of Scotland Cancer Research Network • South-East Scotland Cancer Research Network Northern Ireland Cancer Research Network (NICRN) Wales Cancer Trials Network (WCTN) Size of dot represents network population

  11. NIHR • National Institute for Health Research “Best Research for Best Health” • providing the NHS with the support and facilities it needs for first class research : • Clinical research networks for England • Research Centres • Biomedical Research Units • Experimental medicine facilities • Technology platforms • Research Design Centres

  12. NIHR Portfolio rules • NIHR defined portfolio criteria • Majority of ££ from NIHR partners (National funders – HTA, CRUK) • CTAAC approved studies, even if not CTAAC funded • Adopted Fully funded pharmaceutical studies • Foreign government funded studies • Peer reviewed Academic Pharma funding • EORTC and other high quality studies

  13. Comprehensive networks • Provide Service support costs for research in the NHS • TCRNs, PCRN and all other diseases • Unblocking research barriers • Pharmacy, Radiology etc. • Provide research governance • “R&D/ Management approval” • Estimate that more money is spent on NHS cancer research costs outside NCRN than inside….all of this will come through Comprehensive networks……..

  14. Challenges for us • Networks are the new model • Do we act like networks? • NCRN review Jan 2009 • Much greater emphasis on speed of accrual • Justification of a special Cancer Network….

  15. Pressures • Slow recruiting trials • Have to work together to solve what can be solved • Cancer most mature network • Often selected to try things out • Mistakes very public! • Industry……..

  16. Speed • Speed of opening • CSP & Comprehensive networks • Do our bit efficiently • Effective negotiation with Trusts & Commissioners • Speed of accrual • Think how to do this most effectively • Share best practise • Identify barriers & TELL US if outwith your control • Share patients……

  17. Networks • Evidence of network benefits • Working with service networks • Impacting on local services • Working with local researchers • Cancer • Non-Cancer • Working with local consumers • Working as a network • Not just an administrative unit

  18. Pilot approach to slow recruiters • Parallel the Industry trial ideas.. • Identify some key trials • Identify potential solutions • Collate information from PIs/RNMs/CLRs • Meeting/TC • Chief Investigator (+- other TMG members) • CTU • CSG input • Representative RNMs

  19. Targets v points? • Improve patient outcome • Speedy accrual to trials • Increase RCT accrual • Maintain non-RCT accrual

  20. What does this mean? • Breast portfolio – National priorities? • Sofea ALTTO IBIS-II

  21. What does this mean? • Breast portfolio – National priorities? • Sofea = ALTTO = IBIS-II • All top priority studies • All CTAAC approved RCTs in the NCRN portfolio • Non-cancer patients cannot count in the 7.5% as they don’t have cancer • All patients count towards speed of accrual targets • Local priorities will vary – non-Stalinist….

  22. Summary • Balance of the portfolio • Diseases/ treatments/ genetics/ supportive • Speed • Open studies and get on with accrual…. • Overall recruitment • More patients, more answers

  23. Summary • Balance of the portfolio • Diseases/ treatments/ genetics/ supportive • Speed • Open studies and get on with accrual…. • Overall recruitment • More patients, more answers • Industry is a core business

  24. Summary • Balance of the portfolio • Diseases/ treatments/ genetics/ supportive • Speed • Open studies and get on with accrual…. • Overall recruitment • More patients, more answers • Industry is a core business • Work as networks

  25. Delivering with the Pharmaceutical Industry

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