Shutterstock / Avarand
On any given day, cancer patients can scan through thousands of open clinical trials for experimental treatments in the United States.
But only a tiny set of those with the disease ever take part, and some 40 percent of trials fail to enroll enough patients to produce statistically relevant results, studies have found. It means that some patients don’t pursue treatments that may extend their lives — and that researchers don’t acquire the data that moves science closer to cures.
TrialReach wants to change that by making it easier for patients and families struggling with all kinds of diseases to find promising trials and to understand whether they can participate.
The five-year-old London startup developed a central database that provides patients with free access to a growing number of clinical trials around the world, as well as simplified explanations of inclusion requirements. The company told Re/code it just formed a relationship with the World Health Organization that will bring the number of trials on the site to 270,000, more than triple the number today.
“We’ll become effectively the biggest source for clinical trials that’s ever existed, on or offline,” said Pablo Graiver, chief executive of TrialReach, in an interview.
Access to the WHO’s International Clinical Trial Registry Platform adds to existing relationships with the National Institute for Health Research and CenterWatch.
TrialReach takes unstructured information from trial descriptions and translates the dense science and legalese into simple language, using a combination of natural language processing technology and human editing. The descriptions are then evaluated by institutional review boards that oversee clinical trials.
The company also puts the information in front of more patients by offering health sites their clinical trial data in the form of embeddable widgets. That network reaches roughly 60 million people a month, Graiver said.
“It should be mandatory that all clinical trials have a plain English summary because, at the end of the day, it’s for us, it’s for patients, it’s our decisions,” he said. “We believe very much in patient empowerment and patient centricity around research. Until now, the model has been researcher centric.”
The company has raised $4.5 million in two funding rounds from Octopus Ventures, Amadeus Capital Partners and others. TrialReach makes money by charging research organizations, including pharmaceutical companies, when they’re connected to prescreened patients.
Importantly, it’s the patient who must request to be connected to the researchers conducting the trials. No information is ever shared until that point, patient lists are never sold and there is no marketing on the site.
Information on medical trials in the United States is already available at ClinicalTrials.gov. But Graiver contends that many people don’t take part because they don’t know where to find the information, they don’t understand it or their doctors don’t recommend it.
Physician influence is the single biggest factor in enrolling patients into clinical trials. A report funded by the National Institutes of Health found: “More than half of the women surveyed said their oncologists never mentioned clinical trials to them or actively discouraged them from participating. Oncologists who did recommend trials to patients were usually investigators themselves or recommending a trial at their own institution.”
By making the information less intimidating and more widely available, TrialReach hopes to empower patients to make decisions on their own. People are using technology to exercise greater control over their health care in many other contexts, including using online medical sites, health apps, wearables and more. The shift is often called the consumerization of health care.
“We see it as part of a much bigger movement that’s happening,” Graiver said. “We’re democratizing the whole sector.”
But more patient participation doesn’t automatically result in breakthrough treatments — and clearer information won’t always mean more people will enroll in trials.
There are a variety of other factors that discourage people from taking part, including the loss of control over treatment decisions, the cost of getting to trials in other parts of the country and the basic human fear that participating in an experiment means you’ve reached the option of last resort.