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pdfAACI – NCI CLINICAL TRIALS
REPORTING PROGRAM (CTRP)
STRATEGIC SUBCOMMITTEE REPORT
CTRP Reporting Objectives and
Implementation Timeline
July 2011
AACI – NCI Clinical Trials Reporting Program (CTRP) Strategic Subcommittee Report
Table of Contents
I.
EXECUTIVE SUMMARY
2
II. INTRODUCTION
a.
5
Background
III. CTRP TRIAL REGISTRATION
a.
b.
c.
d.
e.
f.
6
IV. CTRP PATIENT ACCRUAL REPORTING
a.
b.
c.
d.
13
15
Outcome Reporting Requirement
VI. TIMELINES: (SEE APPENDIX B)
a.
b.
c.
d.
15
16
NCI Support
VIII. TOPICS REQUIRING ADDITIONAL CONSIDERATION
a.
b.
c.
d.
e.
f.
20
Appendix A: Members of the CTRP Strategic Subcommittee
Appendix B: Timelines
Appendix C: Data Elements for Registration
Appendix D: Data Elements for Accrual
1
17
Reporting Non‐Interventional Trials in CTRP
Patient‐Level Disease Coding for Accrual
CTRP Summary 4 Reports
Institutions without Automated Systems
Process for Changing CTRP Technical Specifications
Report Dissemination
IX. APPENDICES
a.
b.
c.
d.
Timelines for Registration
Timelines for Reporting Amendments, Updates, and Status Changes
Timelines for Reporting Patient Accrual
Workload Estimate for CTRP Registration and Accrual Reporting
VII. SUPPORT
a.
Data Elements ‐ Complete Registration (National, Externally Peer‐Reviewed, Institutional Trials)
Data Elements ‐ Abbreviated Registration (Industrial Trials)
Methods for Patient Accrual Reporting
Guidelines for Patient Accrual Reporting
V. CTRP OUTCOMES REPORTING
a.
Scope
Categorization
Data Elements ‐ Complete Registration (National, Externally Peer‐Reviewed, Institutional Trials)
Data Elements ‐ Abbreviated Registration (Industrial Trials)
Methods for CTRP Trial Registration
Amendments/Status Changes/Updates
AACI – NCI Clinical Trials Reporting Program (CTRP) Strategic Subcommittee Report
I. Executive Summary
The need for a single central repository of National Cancer Institute (NCI)‐supported clinical
trials has been long‐standing. In 2005, the Clinical Trials Working Group (CTWG)
recommended the development of “a shared foundation of comprehensive, up‐to‐date
information about the status of cancer clinical trials.” The NCI has no electronic database
for more than half of its clinical trials portfolio, accounting for more than 20,000 patients
each year, most of which are conducted with grant support (e.g., R01s, R21s, P01s, SPOREs,
those taking place in NCI‐designated Cancer Centers, etc.). Thus, currently available
databases do not allow NCI to monitor accrual for all NCI‐supported trials. A
comprehensive database of the entire NCI portfolio would help to identify gaps in clinical
research and duplicative studies, as well as facilitate effective clinical trial prioritization. The
April 2010 Institute of Medicine report “A National Cancer Clinical Trials System for the 21st
Century: Reinvigorating the NCI Cooperative Group Program” reiterated the need for a
comprehensive database of cancer clinical trials.
In 2010, the Clinical Trials Reporting Program (CTRP) Strategic Subcommittee, co‐chaired by
Dr. Kevin Cullen, Director, University of Maryland Greenebaum Cancer Center, and Dr.
Sheila Prindiville, Director, Coordinating Center for Clinical Trials, NCI, was formed in
collaboration with members of the NCI cancer research community, leadership of NCI‐
designated Cancer Centers and the AACI. The charge of the subcommittee was to identify
current and estimated future workload and timeframe to meet CTRP information
requirements for: 1) registration; 2) accrual (summary, patient level with demographics,
disease coding); and 3) outcomes. Specific agenda topics included: 1) summary of
experience with CTRP registration; 2) review of data elements for registration,
amendments, updates, accrual, and outcomes; 3) report on the status of vendor integration
and their estimates to automate registration and accrual reporting (e.g., Forte Research
Systems, Velos); 4) timeline for adoption of reporting requirements; and 5) policy on
reporting by trial type.
The subcommittee met by teleconference six times between August 2010 and February
2011. During the first several meetings, the subcommittee reviewed the rationale and
current status of CTRP. It was agreed that the primary goal of CTRP is to be a central
repository of all NCI‐supported clinical trials with accrual data that will enable NCI to
efficiently manage its clinical research portfolio. Each trial that is submitted to CTRP is
abstracted by CTRP staff. These abstracts are indexed with terminology that optimizes
retrieval of cancer clinical trials that are made available to the public through the NCI’s Web
site (http://www.cancer.gov).
During the initial development of CTRP, concern arose in the extramural community that
CTRP would increase the workload for cancer clinical researchers and would duplicate the
clinical trial reporting to Clinicaltrials.gov required by the Food and Drug Administration
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AACI – NCI Clinical Trials Reporting Program (CTRP) Strategic Subcommittee Report
Amendments Act of 2007 (FDAAA) and as a condition of subsequent publication by the
International Committee of Medical Journal Editors (ICMJE). However, the development of
CTRP began several years before the enactment of the FDAAA, Title VIII, Section 801, which
mandates that a "responsible party" (i.e., the sponsor or designated principal investigator)
register and report results of certain "applicable clinical trials." 1 Furthermore, CTRP is
designed to meet the unique needs of those searching for and/or monitoring cancer clinical
trials, whereas Clinicaltrials.gov includes clinical trials for all types of illness. Since the
enactment of FDAAA, CTRP provides institutions that submit trials with a data file suitable
for submission to Clinicaltrials.gov after independent review and validation by the
responsible party, eliminating the need for duplicate entry of required data elements to
both systems.
The subcommittee then reviewed the workflow, including the required data elements, for
listing trials in CTRP. The subcommittee concurred that the scope of trials for registration in
CTRP should include NCI‐supported interventional cancer clinical trials open to patient
accrual as of or after January 1, 2009. The scope of NCI‐supported interventional trials
includes all interventional cancer clinical trials taking place in NCI‐designated Cancer
Centers, as well as other NCI‐supported trials, such as NCI Cooperative Group trials and
trials conducted as part of an NCI grant. There are two types of trials registered in CTRP: 1)
clinical trials managed by the Cancer Therapy Evaluation Program (CTEP) and Division of
Cancer Prevention (DCP) Protocol and Information Offices (PIOs), and clinical trials
conducted in the Center for Cancer Research (CCR), and 2) other NCI‐supported trials.
Registration data for clinical trials managed by the CTEP and DCP PIOs will be transferred
within NCI to CTRP; thus investigators of these trials do not need to register these trials in
CTRP. Other NCI‐supported trials will be registered directly in CTRP by the NCI‐supported
entity. At the time of registration, clinical trials will be categorized in one of the four
Summary 4 2 categories: 1) National, 2) Peer‐Reviewed, 3) Institutional, or 4) Industrial.
The subcommittee discussed the type and frequency at which changes to a clinical trial
protocol should be submitted to CTRP. Amendments should be submitted to CTRP within
20 days of the approval of the change in a protocol document by the Institutional Review
Board (IRB), and updates should be submitted annually. Status changes should be
submitted as soon as possible, but no later than 30 days after the status change has taken
place.
The subcommittee reviewed the accrual data proposed for submission to CTRP. CTRP is
building an accrual module to capture patient‐level data elements based on CTEP’s Clinical
Data Update System (CDUS) Abbreviated. 3 Currently, accrual data can be entered manually
via the CTRP Web site; batch submission and web service specifications are targeted for
1
(http://prsinfo.clinicaltrials.gov/fdaaa.html)
Summary 4 is an annual clinical trials reporting requirement required by the NCI in order to qualify for a Cancer
Center Support Grant. (http://cancercenters.cancer.gov/documents/Summaries6_06.pdf)
3
Clinical Data Update System (CDUS) Abbreviated
(http://ctep.cancer.gov/protocoldevelopment/electronic_applications/docs/cdus_inst_guidev20.pdf)
2
3
AACI – NCI Clinical Trials Reporting Program (CTRP) Strategic Subcommittee Report
completion in September 2011. After these specifications are published, software vendors
providing clinical data management system (CDMS) support and organizations with in‐
house systems will be able to develop applications to support automated reporting of
accrual data to CTRP. For National, Peer‐Reviewed, and Institutional trials, the Lead
Organization will report patient accrual for all participating sites on a trial. For Industrial
trials, summary accrual information will be reported by the Participating Organization. For
all trials, patient accrual will be reported quarterly. Accrual reporting specifications for
CTRP will be designed so that each cancer center’s accrual to a study is appropriately
counted.
The subcommittee then reviewed the timeline for CTRP registration and accrual reporting.
Initial registration of trials conducted by NCI‐designated Cancer Centers should be complete
by October 2011. Other grantee institutions conducting NCI‐supported trials should
develop processes and complete initial trial registration by January 2012.
Data elements and specifications for automated submission of amendments, updates, and
trial status changes are targeted for completion in June 2011. Amendments, updates, and
status changes are to be submitted within 9 months after the communication of the
specification. NCI‐designated Cancer Centers should develop processes and begin
submitting amendments, updates, and status changes by March 2012. Other grantee
institutions conducting NCI‐supported trials should begin submitting amendments, updates,
and status changes for NCI‐supported trials by June 2012.
Data elements and specifications for submission of patient accrual data are targeted for
completion in September 2011. Automated reporting of accrual is anticipated 12 months
after the accrual specification is made available. NCI‐designated Cancer Centers should
develop processes and begin submitting accrual by September 2012. Other grantee
institutions conducting NCI‐supported trials should develop processes and begin submitting
accrual by January 2013.
The subcommittee recommended the creation of a working group, to include
representatives from interested clinical data management systems (CDMSs) vendors, plus
sites developing and/or maintaining in‐house CDMSs, as well as representatives of NCI and
at least two participating cancer centers. This working group would evaluate the cost and
timeline for implementation of future changes to registration, amendment, update, status
and accrual specifications.
Although the original CTWG report discussed the desirability of outcome reporting,
including toxicity and adverse event reporting, based on CDUS Complete, the CTRP Strategic
Subcommittee concluded that it is premature to define outcome reporting requirements
and timelines for CTRP. Instead, they recommended deferring capture of outcomes data in
CTRP for 3‐5 years. They recommended that during that time, a group, with extramural
representation, should work with NCI to identify the outcomes data elements, the
implementation and cost, and the timeframe for implementation.
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AACI – NCI Clinical Trials Reporting Program (CTRP) Strategic Subcommittee Report
NCI reiterated its continued support to grantees and software vendors to facilitate
registration and accrual reporting. Examples of NCI support included funding supplements
to NCI‐designated Cancer Center grants to support start‐up costs for CTRP reporting
requirements; professionally written abstracts following clinical trial registration and a data
file suitable for posting in Clinicaltrials.gov after review; and technical support, user calls,
etc., to support the CTRP community.
The subcommittee acknowledged that there were areas that would require continued
consideration and discussion, including the reporting of non‐interventional trials in CTRP,
patient‐level disease coding, the design and implementation of CTRP‐generated Summary 4‐
type reports, and how to support or adjust timelines for centers without a CDMS.
Finally, the subcommittee suggested broad dissemination of the CTRP Strategic
Subcommittee final report and recommendations, through channels including: 1) NCI’s
CTRP Web site; 2) Cancer Center Administrators Forum; and 3) Association of American
Cancer Institutes’ Clinical Research Initiative.
II. Introduction
a. Background
In January 2004, the director of the National Cancer Institute (NCI) established the Clinical
Trials Working Group (CTWG) to advise the National Cancer Advisory Board (NCAB) on
whether and in what ways the NCI‐supported national clinical trials enterprise should be
restructured to realize the promise of molecular medicine for advancing oncologic clinical
practice in the 21st century. The result of the CTWG's work was a compendium of 22
initiatives detailed in the group's 2005 report “Restructuring the National Cancer Clinical
Trials Enterprise.” 4 First and foremost in the report is a series of coordination initiatives. As
the report notes:
The CTWG envisions an enhanced cancer clinical trials enterprise in
which increased participation by the extramural community in the
prioritization process more effectively focuses resources on those trials
judged most likely to facilitate advances in treatment. The success of
this strengthened prioritization process depends on a shared
foundation of comprehensive, up‐to‐date information about the status
of cancer clinical trials.
4
“Restructuring the National Cancer Clinical Trials Enterprise” (http://transformingtrials.cancer.gov/files/ctwg‐
report.pdf)
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AACI – NCI Clinical Trials Reporting Program (CTRP) Strategic Subcommittee Report
The CTRP fulfills a major initiative of the CTWG report, to provide a shared foundation of
information by establishing a comprehensive database containing regularly updated
information on all NCI‐supported clinical trials. The expected benefits articulated by the
CTWG include:
• Investigators would be aware of other NCI‐supported clinical trials already
completed or underway that are addressing similar questions when preparing new
trial concepts and proposals.
• Prioritization would be enhanced by having available a full picture of the cancer
clinical trials enterprise.
• Patient accrual to trials may be enhanced because physicians and patients would be
aware of relevant opportunities for participation in clinical trials.
In April 2010, the Institute of Medicine released a report titled “A National Cancer Clinical
Trials System for the 21st Century: Reinvigorating the NCI Cooperative Group Program” 5
which reiterated the need for a complete database of clinical trials, with a standardized and
accessible infrastructure supporting electronic data capture.
The CTRP Strategic Subcommittee, co‐chaired by Dr. Kevin Cullen, Director, University of
Maryland Greenebaum Cancer Center, and Dr. Sheila Prindiville, Director, Coordinating
Center for Clinical Trials, NCI, was formed in 2010. Members of the CTRP Strategic
Subcommittee include individuals from cancer centers who are responsible for the day‐to‐
day operations of cancer center clinical trials offices as well as physicians who conduct
clinical trials. The subcommittee identified appropriate data elements for registration and
accrual reporting, suggested appropriate timelines for instituting automated processes for
CTRP reporting, proposed resources that will be required for implementation of CTRP, and
noted other issues requiring additional consideration. This report summarizes the work of
the CTRP Strategic Subcommittee.
III. CTRP Trial Registration
a. Scope
All NCI‐supported interventional trials open to patient accrual as of or after January 1, 2009,
are to be registered in CTRP, including all trials in the following Summary 4 6 clinical research
categories:
1) Clinical trials involving an agent or device
5
“A National Cancer Clinical Trials System for the 21st Century: Reinvigorating the NCI Cooperative Group
Program” http://www.iom.edu/Reports/2010/A‐National‐Cancer‐Clinical‐Trials‐System‐for‐the‐21st‐Century‐
Reinvigorating‐the‐NCI‐Cooperative.aspx
6
Summary 4 is an annual clinical trials reporting requirement required by the NCI in order to qualify for a Cancer
Center Support Grant. (http://cancercenters.cancer.gov/documents/Summaries6_06.pdf)
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AACI – NCI Clinical Trials Reporting Program (CTRP) Strategic Subcommittee Report
2) Clinical trials involving other types of interventions (i.e., behavioral modification,
nutritional protocols, etc.)
Note: Trials in the following Summary 4 clinical research categories are not currently in
scope for CTRP:
1) Epidemiologic, outcome, or other observational studies
2) Ancillary or correlative studies associated with a clinical trial and other biological
studies using clinical specimens that can be linked to individual patients or
participant data
NCI‐supported trials include:
• All NCI Cooperative Group trials
• Any trial conducted at an NCI‐designated Cancer Center (with P30 center core
grant), including all industrial trials
• Trials conducted under any type of contract, grant, or cooperative agreement
supported by the NCI (e.g., R01, N01, SPOREs, P01, U01, U10)
Timing: Trials open to patient accrual as of or after January 1, 2009. Trials are to be
registered prior to the enrollment of the first patient.
There are two types of trial registration:
1) Trials Managed by the Cancer Therapy Evaluation Program (CTEP) or Division of
Cancer Prevention (DCP) Protocol and Information Offices (PIO) and Trials
Managed by the Center for Cancer Research (CCR): These trials will be registered
by the NCI and do not need to be registered separately in CTRP by the institution
conducting the trial. Examples of trials managed by the CTEP or DCP PIO include:
• Phase I trials under CTEP Investigational Drug Branch grants (U01s)
• Phase II trials under CTEP Investigational Drug Branch contracts (N01s)
• DCP Chemoprevention contracts
• DCP Community Clinical Oncology Program (CCOP) trials
• NCI Cooperative Groups trials
2) Other NCI‐supported trials: All other NCI‐supported trials will be registered directly
in CTRP by the institution conducting and/or participating in the trial.
b. Categorization
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AACI – NCI Clinical Trials Reporting Program (CTRP) Strategic Subcommittee Report
At time of registration, trials will be categorized in one of the following categories,
consistent with Summary 4 reporting guidelines:
• National: National Cooperative Group Trials.
• Externally Peer‐Reviewed: R01s, SPORES, U01s, U10s, and P01s or other trial
mechanisms supported by the NIH or supported by other peer‐reviewed funding
organizations.
• Institutional: In‐house trials authored or co‐authored by cancer center investigators
and undergoing scientific peer‐review solely by the Protocol Review and Monitoring
System of the center. The center investigator should have primary responsibility for
conceptualizing, designing, and implementing the trial and reporting results. It is
acceptable for industry and other entities to provide some support (e.g., drug,
device, other funding) but the trial should clearly be the intellectual product of the
center investigator.
• Industrial: Design and implementation of the study is controlled by the
pharmaceutical company.
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AACI – NCI Clinical Trials Reporting Program (CTRP) Strategic Subcommittee Report
c. Data Elements ‐ Complete Registration (National, Externally Peer‐Reviewed,
Institutional Trials)
Registration Data Elements 7
Mandatory = M
Optional = O
Conditional = C
Lead Organization
NCT Number 8
Other Identifiers
Title
Phase
Trial Type
Purpose
Principal Investigator
Sponsor and Responsible Party
Trial Submission Category
Summary 4 Funding Sponsor
Program Code
NIH Grant Information
Current Trial Status and Status Dates
IND/IDE Information
Protocol Document
IRB Approval
List of Participating Sites
Informed Consent Document
Regulatory Information 10
M
O
O
M
M
M
M
M
C (Mandatory if XML 9 is requested)
M
M
O
O
M
O
M
M
O
M
C (Mandatory if XML is requested)
7
Definitions of the data elements can be found in Appendix C
Clinicaltrials.gov registry number
9
XML is Extensible Markup Language, e.g., an electronic data file suitable for submission to Clinicaltrials.gov after
review
10
Regulatory Information includes trial oversight authority country; trial oversight authority organization name;
FDA regulated intervention indicator; Section 801 indicator; delayed posting indicator; and data monitoring
appointed indicator. See http://prsinfo.clinicaltrials.gov/definitions.html
8
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AACI – NCI Clinical Trials Reporting Program (CTRP) Strategic Subcommittee Report
d. Data Elements ‐ Abbreviated Registration (Industrial Trials)
Registration Data Elements 11
Mandatory = M
Optional = O
Conditional = C
Lead Organization
NCT Number 12
Lead Organization Trial Identifier Number
Title
Submitting Organization Name
Submitting Organization Local Trial Identifier
Phase
Trial Type
Purpose
Site Principal Investigator
Confirmation that Trial Submission Category is Industrial
Summary 4 Funding Sponsor Type
Site‐Specific Program Code
Current Site‐Specific Trial Status
Date Reporting Site Open to Accrual
Date Reporting Site Closed to Accrual
Trial related documents 13
M
O
M
M
M
M
M
M
M
M
M
M
O
M
C (M when date known)
C (M when date known)
O
e.
Methods for CTRP Trial Registration
Clinical trials may be registered via one of the following three mechanisms:
1) CTRP Registration Web Site (https://trials.nci.nih.gov/registry/home.action)
2) Batch file submission (http://www.cancer.gov/clinicaltrials/ctrp/page11)
3) Web Services (http://www.cancer.gov/clinicaltrials/ctrp/page11)
11
Definitions of the data elements can be found in Appendix C
Clinicaltrials.gov registry number
13
Trials‐related documents include other documents that the submitter may want to provide, e.g., completion of
an abbreviated trial submission template, etc.
12
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AACI – NCI Clinical Trials Reporting Program (CTRP) Strategic Subcommittee Report
f.
Amendments/Status Changes/Updates
1) Definitions:
Amendments: Amendments include changes that: 1) substantively alter the
treatment administered; and/or 2) the study design; and/or 3) the sites in which
patients are being enrolled on the trial. Amendments are to include all changes
(including updates) since the last change to the protocol was submitted.
Examples of amendments include:
• Dose Escalation Amendment (e.g., change in the number of patients
treated at a given dose level)
• Change in Sites Open to Patient Accrual
• Change in Principal Investigators
• Change in Risk to Participants (e.g., new risk identified [new CAEPR],
changes made as a result of an updated Severe Adverse Event)
• Scientific Change (e.g., opening an arm, adding a new arm, closing an
arm, changing objectives, changing statistical analysis, adding correlative
studies, increase or decrease in the accrual goal, changing from Phase I to
Phase II, additional data points)
• Correction of Typographical Errors which Change Scientific Meaning
(e.g., mg vs. mcg)
• Eligibility Change (change to the inclusion or exclusion criteria)
• Therapy Change (e.g., change in dose, adding another agent, change in
administration, change in route)
Status Changes: Status changes include changes in the overall status of the trial
(e.g., a change from active to temporarily closed to accrual, a change from
temporarily closed to accrual to complete, etc).
Updates: Updates are defined as other changes to the protocol that do not
substantively affect the scientific conduct of the study, the study design, and/or
the sites in which patients are being enrolled on the trial. The following types of
changes will be considered updates:
• Editorial, Administrative Changes (correction of minor typographical
errors; clarifications made to previously approved descriptions of
research)
• Data, Data Collection, and Data Collection Materials (revised study
diaries; revised questionnaires or QOL surveys given to participants)
• Recruitment of Subjects (changes in the way subjects are recruited; new
or revised advertisement)
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AACI – NCI Clinical Trials Reporting Program (CTRP) Strategic Subcommittee Report
• Change in Principal Investigator Contact Information
2) Frequency for submission:
Amendments: All amendments are to be submitted within 20 days of the
approval of the change in the protocol by the institution’s IRB. An amendment
submission is to include all changes to the clinical trial (including any updates)
since the last submission.
Status Changes: Trial owners are asked to submit these changes as quickly as
possible, so that publicly available Web sites reflect the correct status of the
trial. However, these changes are to be submitted to CTRP no later than 30
days after they have taken place.
Updates: Updates are to be submitted annually.
3) Documentation to be submitted with amendments, updates, or status changes:
Amendments: The submitter is asked to submit the following:
• A copy of the revised protocol document showing the changes since the
last submission; or
• A copy of the revised protocol document that was sent to the IRB clearly
indicating these changes and/or a document that lists all changes since
the last submission; or
• For centers with an electronic IRB approval system and/or centers that do
not have a change memo readily available for submission, a redline and
strikeout protocol document showing the changes in the document itself
is an acceptable alternative.
Updates: Once each year, the submitter is to provide:
• A list of all changes made to the protocol since the last amendment or
update was submitted, or
• For a study that provides an annual update to the IRB, a copy of this
annual update will meet this requirement, or
• For centers with an electronic IRB approval system and/or centers that do
not have a change memo readily available for submission, a redline and
strikeout protocol document showing the changes in the document itself
is an acceptable alternative.
• Updates are to be submitted at least once each year, even if no changes
have occurred. A copy of the annual report to the IRB will suffice.
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AACI – NCI Clinical Trials Reporting Program (CTRP) Strategic Subcommittee Report
Status Changes:
• These can be entered in the CTRP user interface.
• The attachment of a revised protocol document or change memo is
optional.
IV. CTRP Patient Accrual Reporting
a.
Data Elements ‐ Complete Registration (National, Externally Peer‐Reviewed,
Institutional Trials)
Protocol Administrative Data
Elements 14
Mandatory = M
Optional = O
Conditional = C
NCI Protocol Number
CTEP/DCP Protocol Number
Date Report Submitted
Cut‐Off Date for Data
Current Protocol Status
Submitter Name and Contact Information
M
C (Mandatory if CTEP/DCP PIO managed trial)
M
M
M
O
Patient Demographic Information
Mandatory = M
Optional = O
Conditional = C
Patient ID
Patient Zip Code
Patient Country Code
Patient Birth Date (Month/Year)
Patient Gender
Patient Ethnicity
Patient Method of Payment
Date of Patient Entry
Patient Disease Code 15
M
C (Mandatory if US)
C (Mandatory if not US)
M
M
M
O
M
C (Mandatory for all trials except DCP PIO trials
registered in CTRP by NCI
M
Patient Race
14
15
Definitions of the data elements can be found in Appendix D
Either CTEP Simplified Disease Codes (SDC) or ICD‐9 codes are acceptable
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AACI – NCI Clinical Trials Reporting Program (CTRP) Strategic Subcommittee Report
b.
Data Elements ‐ Abbreviated Registration (Industrial Trials)
Protocol Administrative Data Elements 16 Mandatory = M
Optional = O
Conditional = C
NCI Protocol Number
CTEP/DCP Protocol Number
Date Report Submitted
Cut‐Off Date for Data
Current Protocol Status
Submitter Name and Contact Information
M
C (Mandatory if CTEP/DCP PIO managed trial)
M
M
M
O
Accrual During Reporting Period
Mandatory = M
Optional = O
Conditional = C
Number of patients accrued at site
M
c.
Methods for Patient Accrual Reporting
The CTRP system was enhanced in the beginning of 2010 to allow submission of patient
accrual through the CTRP Accrual Web Site based on the CDUS Abbreviated
specification. This was tested by CTRP pilot sites with most sites requesting an
automated method (i.e., batch or services) for reporting patient accrual rather than
doing so manually. The specification for automated patient accrual reporting is targeted
for finalization in September 2011. Accrual is to be submitted within 12 months after
the specification is made available. NCI will partner with the key CDMS vendors used by
the cancer centers community (e.g., Medidata, Forte Research Systems, and Velos) to
develop an automated mechanism for delivering registration and accrual information to
NCI. CDUS reporting guidelines are not changed and accrual data reported to NCI via
CDUS will be transferred within NCI to CTRP.
d.
Guidelines for Patient Accrual Reporting
There are two types of CTRP trials for which patient accrual will be reported:
1) Trials managed by the CTEP or DCP PIOs and CCR ‐ Accrual for these trials
will be entered in CTRP by the NCI. Examples of trials managed by the CTEP
or DCP PIO include:
16
Definitions of the data elements can be found in Appendix D
14
AACI – NCI Clinical Trials Reporting Program (CTRP) Strategic Subcommittee Report
•
•
•
•
•
Phase I trials under CTEP Investigational Drug Branch grants (U01s)
Phase II trials under CTEP Investigational Drug Branch contracts (N01s)
DCP Chemoprevention contracts
DCP Community Clinical Oncology Program (CCOP) trials
NCI Cooperative Groups trials
2) Other NCI‐Supported trials ‐ Accrual for all other NCI‐supported trials will be
entered in CTRP as outlined below:
• Patient‐Level Accrual will be reported for National, Externally Peer‐
Reviewed, and Institutional Trials. The Lead Organization will report
patient accrual for its site and all participating sites.
• Summary Accrual (cumulative count only) will be reported for Industrial
trials by participating sites.
Accrual data will be reported quarterly.
V. CTRP Outcomes Reporting
a.
Outcome Reporting Requirement
The CTWG report discussed elements of outcome reporting, including toxicity and
adverse event reporting. The CTRP Strategic Subcommittee recommended deferring
capture of outcome data for 3‐5 years. During that time, a group, with extramural
representation, should work with NCI to identify the outcomes data elements, the
proposed implementation and cost, and the timeframe for implementation.
VI. Timelines: (See Appendix B)
Institution workload assessments and estimated time for vendors of CDMSs (e.g. Velos,
Forte Research Systems) to implement automated reporting were taken into account in
developing timelines.
a. Timelines for Registration
1) NCI‐designated Cancer Centers: initial registration of trials conducted by NCI‐
designated Cancer Centers should be complete by October 2011.
2) Other Grantee Institutions conducting NCI‐supported trials should develop
processes and complete initial trial registration by January 2012.
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AACI – NCI Clinical Trials Reporting Program (CTRP) Strategic Subcommittee Report
b. Timelines for Reporting Amendments, Updates, and Status Changes
The specification for automated amendments, updates, and status changes is targeted
for finalization in June 2011. The reporting of amendments and updates is to begin 9
months after the specification is made available.
1) NCI‐designated Cancer Centers should develop processes and begin
submitting amendments, updates, and status changes by March 2012.
2) Other Grantee Institutions conducting NCI‐supported trials should develop
processes and begin submitting amendments, updates, and status changes
by June 2012.
c. Timelines for Reporting Patient Accrual
The specification for automated patient accrual is targeted for finalization in September
2011. The reporting of accrual is to begin one year after the specification is made
available.
1) NCI‐designated Cancer Centers should develop processes and begin
submitting accrual by September 2012.
2) Other Grantee Institutions conducting NCI‐supported trials should develop
processes and begin submitting accrual by January 2013.
d.
Workload Estimate for CTRP Registration and Accrual Reporting
The CTRP Strategic Subcommittee prepared an assessment of the workload required to
register and provide accrual data to CTRP, based on the data elements for registration
and patient accrual reporting. Staffing estimates ranged from 1/2 to 2 Full Time
Equivalents (FTEs) to support CTRP reporting. The upper estimates assumed more
manual data reporting; the lower estimates assumed automated reporting through
vendor system integration.
VII. Support
a.
NCI Support
The NCI will continue to support NCI grantees and software vendors to facilitate
registration and the reporting of accrual. Examples of NCI support include funding
supplements to NCI‐designated Cancer Center grants to support start‐up costs of CTRP
reporting requirements, professionally written abstracts following clinical trial
registration, and a data file suitable for posting in Clinicaltrials.gov after review.
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AACI – NCI Clinical Trials Reporting Program (CTRP) Strategic Subcommittee Report
Furthermore, the NCI continues to provide technical support, user calls, etc., to support
the CTRP community.
VIII.
Topics Requiring Additional Consideration
a.
Reporting Non‐Interventional Trials in CTRP
The subcommittee noted that two categories of trials required for preparation of
Summary 4 are not currently registered in CTRP: 1) epidemiologic, outcome, or other
observational studies and 2) ancillary or correlative studies associated with a clinical trial
and other biological studies using clinical specimens that can be linked to individual
patient or participant data. The subcommittee agreed that reporting these trials to CTRP
requires additional deliberation. It recommended that registration of these trials be
deferred until complete registration of all interventional trials has been achieved and
after NCI, in collaboration with the extramural community, has determined the value of
registering these types of trials in CTRP.
b. Patient‐Level Disease Coding for Accrual
Cancer center members of the subcommittee strongly endorsed using ICD‐9 codes for
reporting patient‐level accrual, to be consistent with the coding required for
preparation of Summary 3 and coding frequently used for other patient data
management applications. However, CTEP requires patient‐level coding from CTEP’s
Simplified Disease Code (SDC) list. Rather than require cancer centers to use CTEP SDC
for coding patient‐level accrual data, the committee suggested that cancer centers
report their data using ICD‐9 and that those reporting data to CTEP continue to use CTEP
SDC. Mappings, if necessary, between CTEP SDC and ICD‐9 might take place within NCI
to standardize patient‐level coding on all data reported to CTRP.
c.
CTRP Summary 4 Reports
The subcommittee noted that it will be critical to design the accrual reporting
specifications in such a way that each cancer center’s accrual to a study is appropriately
counted. It will also be critical for system‐generated reports to accurately attribute
those institution(s) responsible for data management (typically the Lead Organization)
and those institution(s) which have provided the intellectual capital for devising and
implementing the study.
The subcommittee recognized that the accrual reported to CTRP for CTEP and DCP trials
will need to be reviewed to ensure that it is harmonized with that which is needed for
Summary 4 reports.
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AACI – NCI Clinical Trials Reporting Program (CTRP) Strategic Subcommittee Report
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AACI – NCI Clinical Trials Reporting Program (CTRP) Strategic Subcommittee Report
d.
Institutions without Automated Systems
The subcommittee noted that some institutions have no CDMS and may need additional
support or more liberal timelines for meeting reporting guidelines.
NCI will work with these sites to modify timelines and seek to provide additional support
to these sites in the form of making available NCI‐furnished CDMSs to these sites and
potentially provide support for data entry personnel to fill the gap until suitable CDMSs
are in place at all centers as appropriate.
e.
Process for Changing CTRP Technical Specifications
The subcommittee recommended the creation of a working group, to include
representatives from any interested vendors of CDMSs, plus any sites developing and/or
maintaining in‐house CDMSs, as well as representatives of NCI and at least two
participating cancer centers. This working group would evaluate any future changes to
registration, amendments, updates, and accrual specifications and work with affected
stakeholders to ensure timely and accurate implementation.
f. Report Dissemination
1) The CTRP Strategic Subcommittee final report and presentations will be
communicated in various forums, including:
• CTRP Web site
• Cancer Center Administrators Forum
• Association of American Cancer Institutes’ Clinical Research Initiative
2) The NCI Office of Communications and Education will be consulted regarding the
communication of the contents of this report.
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AACI – NCI Clinical Trials Reporting Program (CTRP) Strategic Subcommittee Report
IX. Appendices
a.
Appendix A: Members of the CTRP Strategic Subcommittee
Kevin Cullen, M.D., Co‐Chair, Director, University of Maryland Greenebaum Cancer Center
Sheila Prindiville, M.D., M.P.H., Co‐Chair, Director, Coordinating Center for Clinical Trials,
National Cancer Institute
Rhoda Arzoomanian, M.S.M., Associate Director, Administration, University of Wisconsin
Carbone Cancer Center
Jan Buckner, M.D., Professor of Oncology, Mayo Clinic College of Medicine
Rob DuWors, M.P.A., Deputy Director, Administration and Finance, Jonsson Comprehensive
Cancer Center, UCLA
Alyssa K. Gateman, M.P.H., C.C.R.P., Deputy Director, Quality Assurance Office for Clinical
Trials, Dana‐Farber/Harvard Cancer Center
Collette Houston, Director, Clinical Research Operations, Office of Clinical Research, Memorial
Sloan‐Kettering Cancer Center
Nicholas J. Petrelli, M.D., Medical Director, Helen F. Graham Cancer Center at Christiana Care
Daniel M. Sullivan, M.D., Executive Vice President/Associate Center Director for Clinical
Investigations, Moffitt Cancer Center
James Thomas, M.D., Ph.D., Associate Director, Clinical Investigation, Medical College of
Wisconsin Cancer Center
AACI Liaison:
Janie Hofacker, R.N., M.S., Director of Programs, Association of American Cancer Institutes
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AACI – NCI Clinical Trials Reporting Program (CTRP) Strategic Subcommittee Report
b.
Appendix B: Timelines
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AACI – NCI Clinical Trials Reporting Program (CTRP) Strategic Subcommittee Report
c.
Appendix C: Data Elements for Registration
Data Elements for Registration of National, Externally Peer‐Reviewed, Institutional Trials
COMPLETE
REGISTRATION
DATA ELEMENTS
Mandatory = M
Optional = O
Conditional = C
Definition
Trial Identifiers
The ID exactly as it appears in the protocol
document. For Inter‐Group trials, type the Lead
Group’s trial number. For multisite trials that have
no assigned single center, use the protocol ID.
NCT Number
O
The NCT number assigned to trials that have been
submitted to ClinicalTrials.gov previously.
Other Identifier
O
Additional trial identifier(s) such as unique identifier
from other registries, NIH grant numbers, or
protocol numbers assigned by the review board.
Trial Details
Title
M
Official name of the protocol provided by the study
principal investigator or sponsor (same as in the
protocol document).
Phase
M
Select from list: Phase 0, I, I/II, II, II/III, III, IV, N/A,
Pilot Trial.
Trial Type
M
Select Interventional or Observational.
Purpose
M
Select from list: Treatment, Prevention, Supportive
Care, Screening, Diagnostic, Health Services
Research, Basic Science, Other – Any other type of
trial not included in this list
If Other, is it a pilot trial? Y/N.
Lead Organization/Principal Investigator
Lead Organization
M
Organization responsible for the overall scientific
and administrative coordination, study monitoring,
and data management activities of a given clinical
trial.
Principal Investigator
M
Appointed investigator responsible for conducting
clinical trial, or for multisite trials, the study chair.
Sponsor/Responsible Party *Only if XML Requested
Sponsor
C
Mandatory if XML Requested. Sponsor of the clinical
trial (as defined in 21 CFR 50.3 or successor
regulation).
Responsible Party
C
Mandatory if XML Requested. Sponsor of the clinical
trial (as defined in 21 CFR 50.3 or successor
regulation)
‐ or –
Principal investigator of such clinical trial if so
designated by a sponsor, grantee, contractor, or
awardee, so long as the principal investigator is
responsible for conducting the trial, has access to
and control over the data from the clinical trial, has
the right and ability to publish the results of the
trial.
Responsible Party Email Address
C
Mandatory if XML Requested.
Responsible Party Phone Number
C
Mandatory if XML Requested.
Lead Organization Identifier
M
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AACI – NCI Clinical Trials Reporting Program (CTRP) Strategic Subcommittee Report
Summary 4 Information (for trials at NCI‐designated Cancer Centers)
Trial Submission Category
M
National, Peer‐Reviewed, Institutional, Industrial.
Summary 4 Funding Sponsor
M
Group/Sponsor/Funding Source: Provide the name
of the external sponsor or funding source.
Program Code
O
Cancer center‐specific program code.
NIH Grant Information (for NIH‐supported Trials)
Funding Mechanism
O
NCI code used to identify areas of extramural
research activity applied to various funding
mechanisms.
Institute Code
O
The name of the primary organization responsible
for funding the trial.
Serial Number
O
The 5‐ or 6‐digit number generally assigned
sequentially to a series within an Institute, Center,
or Division.
NCI Division Code
O
Status/Dates
Current Trial Status
M
Select the current stage or state of the trial or study.
Why Study Was Stopped
O
Required for Administratively Complete and
Temporarily Closed statuses only.
Current Trial Status Date
M
Enter the date on which the current trial status
became effective.
Trial Start Date
M
Select Anticipated or Actual.
Primary Completion Date
M
Select Anticipated or Actual.
FDA IND/IDE Information for Applicable Trials
IND/IDE Types
O
Select IND (Investigational New Drug Application) or
IDE (Investigational Device Exemption).
IND/IDE Number
O
For IND trials, type the trial’s FDA‐assigned IND
number.
IND/IDE Grantor
O
Select one of the following grantors:
For IND trials,
•
CDER: Center for Drug Evaluation and
Research
•
CBER: Center for Biologics Evaluation and
Research
For IDE trials,
•
CDRH: Center for Devices and Radiological
Health
IND/IDE Holder Type
O
Select one of the following types: Investigator,
Organization, Industry, NIH, NCI.
NIH Institution, NCI
O
Division/Program Code
Expanded Access
O
If an experimental drug or device is available outside
any clinical trial protocol, select Yes.
Expanded Access Type
O
Select one of the following access statuses:
Available, No Longer Available, Temporarily Not
Available, Approved for Marketing.
Exempt
O
Select Yes only if the IND/IDE is exempt from
reporting in ClincalTrials.gov.
Regulatory Information *Only if XML Requested
Trial Oversight Authority Country
C
Mandatory if XML Requested. Select the country
responsible for trial oversight.
Trial Oversight Authority
C
Mandatory if XML Requested. Select the oversight
Organization Name
organization.
FDA Regulated Intervention
C
Mandatory if XML Requested. Yes or No. If the trial
Indicator
includes a non‐exempt IND/IDE, select Yes.
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AACI – NCI Clinical Trials Reporting Program (CTRP) Strategic Subcommittee Report
Section 801 Indicator
C
Delayed Posting Indicator
C
Data Monitoring Committee
Appointed Indicator
C
Protocol Document
IRB Approval
List of Participating Sites
Informed Consent Document
Other
Mandatory if XML Requested. Yes or No. Only if the
FDA Regulated Intervention Indicator = Yes.
Mandatory if XML Requested. Yes or No. Only if the
Section 801 Indicator = Yes.
Mandatory if XML Requested. Yes or No.
Trial‐Related Documents
M
M
O
M
O
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AACI – NCI Clinical Trials Reporting Program (CTRP) Strategic Subcommittee Report
Data Elements for Registration of Industrial Trials
ABBREVIATED
REGISTRATION
DATA ELEMENTS
Lead Organization
Lead Organization Trial Identifier
Submitting Organization Name
Submitting Organization Local
Trial Identifier
NCT Number
Mandatory = M
Optional = O
Conditional = C
Definition
Trial Identifiers
Organization responsible for the overall scientific
and administrative coordination, study monitoring,
and data management activities of a given clinical
trial.
M
The ID exactly as it appears in the protocol
document. For Inter‐Group trials, type the Lead
Group’s trial number. For multisite trials that have
no assigned single center, use the protocol ID.
M
M
M
O
The NCT number assigned to trials that have been
submitted to ClinicalTrials.gov previously.
Trial Details
Title
M
Official name of the protocol provided by the study
principal investigator or sponsor (same as in the
protocol document).
Phase
M
Select from list: Phase 0, I, I/II, II, II/III, III, IV, N/A,
Pilot Trial.
Trial Type
M
Select Interventional or Observational.
Purpose
M
Select from list: Treatment, Prevention, Supportive
Care, Screening, Diagnostic, Health Services
Research, Basic Science, Other – Any other type of
trial not included in this list. If Other, is it a pilot
trial? Y/N.
Site Principal Investigator
M
Summary 4 Information (for trials at NCI‐designated Cancer Centers)
Trial Submission Category
M
National, Peer‐Reviewed, Institutional, Industrial.
Summary 4 Funding Sponsor
M
Program Code
O
Cancer center‐specific program code.
Status/Dates (site specific)
Site Recruitment Status
M
The current stage or state of the trial or study.
Site Recruitment Status Date
M
The date on which the current trial status became
effective.
Date Opened For Accrual
C
If known, enter the date on which the trial was
opened for accrual.
Date Closed For Accrual
C
If known, enter the date on which the trial was
closed for accrual.
Trial‐Related Documents
Abbreviated Trial Template
O
An Abbreviated Trial Template document is required
if the NCT number was not provided.
Other
O
Complete information on CTRP registration is available in the CTRP Site Registration
User’s Guide on the CTRP Resources page:
http://www.cancer.gov/clinicaltrials/ctrp/page11
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AACI – NCI Clinical Trials Reporting Program (CTRP) Strategic Subcommittee Report
d.
Appendix D: Data Elements for Accrual
Data Elements for Reporting Accrual for National,
Externally Peer‐Reviewed, Institutional Trials
PROTOCOL ADMINISTRATIVE
DATA ELEMENTS
NCI Protocol Number
Mandatory = M
Optional = O
Conditional = C
M
DCP/CTEP Protocol Number
C
Date Report Submitted
Current Protocol Status
Submitter Name and Contact
Information
PATIENT DEMOGRAPHIC
INFORMATION
M
M
O
Patient ID
Mandatory = M
Optional = O
Conditional = C
M
Definition
This is the number assigned to the protocol registered in
CTRP.
Mandatory if this is a protocol managed by the CTEP or DCP
PIO.
Definition
Patient Zip Code (Only first 5
digits)
Patient Country Code
Patient Birth Date
(Month/Year)
Patient Gender
C
Unique identifier (numeric or alphanumeric) assigned to
participants in a study.
If U.S.
C
M
Non‐U.S. only.
The month and year on which the person was born.
M
To be harmonized with CRF Demography.
Patient Ethnicity
M
To be harmonized with CRF Demography.
Patient Method of Payment
O
To be harmonized with CRF Demography.
Date of Patient Entry
M
Provide the date the patient entered the study. Defined as
date the patient signed the Informed Consent form.
Patient Disease Code
C
Patient Race
M
Based on the CTEP standard Simplified Disease Code (SDC);
can be reported using ICD‐9 codes used for Summary 3.
Optional for studies managed by the DCP PIO that are
transferred directly from DCP to CTRP.
To be harmonized with CRF Demography.
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AACI – NCI Clinical Trials Reporting Program (CTRP) Strategic Subcommittee Report
Data Elements for Reporting Accrual for Industrial Trials
PROTOCOL ADMINISTRATIVE DATA
ELEMENTS
NCI Protocol Number
Mandatory = M
Optional = O
Conditional = C
M
DCP/CTEP Protocol Number
C
Date Report Submitted
Current Protocol Status
Submitter Name and Contact
Information
PATIENT DEMOGRAPHIC
INFORMATION
M
M
O
Number of patients accrued at site
Mandatory = M
Optional = O
Conditional = C
M
27
Definition
This is the number assigned to the protocol
registered in CTRP.
Mandatory if this is a protocol managed by the
CTEP or DCP PIO.
Definition
Summary count of patients accrued on protocol
at site.
File Type | application/pdf |
File Title | Clinical Trials Reporting Program (CTRP) |
Subject | AACI – NCI CLINICAL TRIALS REPORTING PROGRAM (CTRP) STRATEGIC SUBCOMMITTEE REPORT |
Author | NCI, AACI |
File Modified | 2011-07-06 |
File Created | 2011-07-06 |