Small Biotechs Could Hurt From Scarcity Of Cancer Trial Participants

It turns out you can have too much of a good thing.

The 1,000-plus immunotherapy trials and competition to develop proprietary versions of virtually the same drugs may prove inhibitory to cancer research, according to the New York Times.

The conditions leave clinical researchers competing for the same patient populations meeting highly specific criteria ━ tiny pools made all the smaller by medical centers declining to participate. This means some companies can’t find enough subjects to test their treatments.

Who Gets Hurt?

Small, unproven pharmaceuticals are largely exposed to these circumstances.

“[Clinical sites] do not want to start a trial a small biotech company cannot finish,” Jason Napodano, managing director of BioNap Consulting, told Benzinga. “That’s a great disservice to the patient. So, sites may shy away from small companies that cannot guarantee they will find enough patients or have enough money to see the trial to completion.”

Any pain from the challenge to find participants is compounded by ensuing trial delays. The hospitals that ultimately agree to contribute patients take time to approve as they sift through floods of proposals.

“The the longer they take, the more the biotech company needs to burn cash while they wait for the results,” Napodano said. “For example, if a company has $20 million and burns $4 million per quarter, they have five quarters before they are out of money. If the trial was supposed to take four quarters but because it is slow to enroll, it now takes five or six quarters, now they are in trouble.”

As it is, small players find it difficult to raise capital for longer trials, which make investors nervous. Additional forfeiture of funding puts any potential progress at risk ━ not only for the firm but for the medical space in which it participates.

On The Other Hand ...

Not all consider the proliferation of trials a negative for the industry.

“Of course, the counter argument is that the more choice the better the end results,” Napodano said. “If you have 100 trials and 10 succeed, now you have 10 new drugs to treat cancer. If you only had 30 trials and three succeed, now you only have three new drugs. So, it’s a Catch-22. You want lots of shots on goal, but you want these shots to be good shots, not junk that clogs the system and ends up hurting patients.”

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