Improving Oncology Trial Experience With Home Trial Support

Author: MRN

Receiving a cancer diagnosis, at any stage, often comes as shock for patients, followed by a level of dread and despair.1,2 These very human emotions are to be expected – it is a diagnosis that will take its toll on the patient and their loved ones. While early diagnosis often means there are established treatments in place, it does not always mean they are accessible for all patients. For rare cancers the treatments options are more severely limited, not matter the stage. And a late-stage cancer diagnosis limits the treatments available even more.

For many patients, turning to a clinical trial can provide both hope and, potentially, care that they may not have had access to. Yet, despite this, oncology trials continue to have both low recruitment and retention rates.3 This is, in-part, due to narrow inclusion/exclusion criteria – but trial protocol complexity, lack of (real or perceived) transparency around treatment and side-affects, and participation burden are all significant contributors to the decision not to join or continue-on in a trial.4

These very real patient concerns around trial participation are the key to unlocking not only recruitment, but also higher retention rates. While some view these hurdles as a complex landscape that needs to be delicately navigated, there are those that view these challenges as a good reason to go back to the drawing board (or even better, start at the drawing board) and review their trial design with one key question in mind – is this trial centered on patient-driven outcomes or data-driven deliverables?

Patient-centricity In Protocol Design

To truly optimize a trial for patients, it requires keeping the patient in-mind right at the very start – protocol design. The Clinical Development team, usually responsible for overseeing the core design of the trial, need to consider the patient experience before, during and after treatment. The level of toxicity of the therapy, the amount of discomfit and pain, and the emotional stress caused will all impact the patient and their family and/or caregivers.

While design teams may be limited as to what they can do to minimize the trauma of receiving treatment,5,6,7 they can assess how and where treatment is delivered and how that can potentially impact the patient’s overall trial experience.

One of the most successful tools that aids in alleviating the physical and emotional distress many cancer patients experience over the course of treatment is Home Trial Support (HTS).8 HTS allows the patient to receive treatment and/or complete portions of their trial activities at home.

Home Trial Support & The Patient Experience

An experienced Healthcare Provider (HCP) is able to perform a variety of tasks that would typically be performed during a site visit. These can include administration of the investigational medicinal product (IMP) / chemotherapy, lab draws, IVs, safety labs, electrocardiograms (ECGs), recording of patient reported outcomes (PROs) and more. Furthermore, this solution, when provided by an experienced vendor, can be scaled on a global level.

For patients, this means that they have the option to have some (predetermined with the Principal Investigator) of their visits at home, or even school or their workplace (the environment will be assessed for treatment suitability). More importantly though, it means that they can receive treatment in a place that is familiar to them and provides the comfort that can make treatment so much more bearable. Family and loved ones are also able to be more present and spend as much time as they would like with the patient, as no hospital visit times apply.

Logistically everything becomes a bit easier for everyone – the patient, their loved ones and/or their caregiver(s). Travel to and from the site is lessened, and time waiting for treatment or other study-related activities is reduced.

From a health perspective, there are a multitude of “hidden” benefits that HTS provides, and for, often immune-compromised, cancer patients one of the key benefits incudes limiting exposure to healthcare associated infections (HAIs) found in medical facility settings.9 These infections are often highly-contagious and while in an ordinarily healthy person can be overcome with minimal intervention, for cancer patients they can turn into hospital stays and can result in serious side-effects.10

Home Trial Support Outcomes

It is not just patients that can benefit from a well-executed HTS solution – sites and sponsors will see a return on their efforts to make the trial more patient-centric.

Primarily, this comes in the form of increased recruitment and retention rates.8 Additionally, for sites, there is an alleviation of trial-related activity burdens with more routine trial activities and administrative tasks being shared with the HTS HCPs. While for sponsors, HTS can give their trial greater reach – meaning more patients from more diverse backgrounds are likely to participate. This in-turn provides sponsors with more representative, quality data for trial submission.

The results are clear – by designing clinical trials that are focused on the patient experience, all those involved in the trial ultimately win. Patients are likely to have improved quality of life, there is less burden on those supporting them through their fight with cancer and sites and sponsors are able to focus on trial execution and data rather than the constant stress and administration of extended recruitment and retention activities.

References:

  1. Gieseler F, et al. Cancer Diagnosis: A Trauma for Patients and Doctors Alike. Oncologist. July 2018. https://pmc.ncbi.nlm.nih.gov/articles/PMC6058334/. Last Accessed August 2025.
  1. Nuru Muhamed A, et al. Lived Experiences of Adult Cancer Patients Undergoing Chemotherapy Treatment at University of Gondar Specialized Hospital, North West Ethiopia, 2021. J Patient Exp. 12 Apr 2023. https://pmc.ncbi.nlm.nih.gov/articles/PMC10102929/. Last Accessed August 2025.
  1. Clinical Trials Arena. How to Recruit and Retain Patients for Oncology Trials. 4 Feb 2018. https://www.clinicaltrialsarena.com/comment/how-to-recruit-and-retain-patients-for-oncology-trials-6045362-2/. Last Accessed August 2025.
  1. Natale P, et al. Transparency, trust and minimizing burden to increase recruitment and retention in trials: a systematic review. Journal of Clinical Epidemiology, Vol134:2021. https://doi.org/10.1016/j.jclinepi.2021.01.014. Last Accessed August 2025.
  1. Macmillan Cancer Support. Physical impacts of cancer and treatment. https://www.macmillan.org.uk/cancer-information-and-support/treatment/physical-impacts-of-cancer-and-treatment. Last Accessed August 2025.
  1. Stein KD, et al. Physical and psychological long-term and late effects of cancer. Cancer Jun 2008;112(11 Suppl). https://pmc.ncbi.nlm.nih.gov/articles/PMC7047657/. Last Accessed August 2025.
  1. El Kheir DYM, et al. Epidemiological assessment of distress during chemotherapy: who is affected?. J Taibah Univ Med Sci. Oct 2019, 8;14(5). https://pmc.ncbi.nlm.nih.gov/articles/PMC6838912/. Last Accessed August 2025.
  1. Medical Research Network. Improved Enrollment & Retention through Home Trial Support – A Case Study. https://themrn.io/wp-content/uploads/2025/08/Turtl-Oncology-Case-Study.pdf. Last Accessed August 2025.
  1. Monegro AF, et al. Hospital-Acquired Infections. StatPearls Publishing. Updated Feb 2023. https://www.ncbi.nlm.nih.gov/books/NBK441857/. Last Accessed August 2025.
  1. American Cancer Society. Why Are People with Cancer More Likely to Get Infections?. https://www.cancer.org/cancer/managing-cancer/side-effects/infections/why-people-with-cancer-are-at-risk.html. Last Accessed August 2025.
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