Overview:
Cancer Trials Support Unit
(CTSU)

Presentation Outline

•      Introduction to the CTSU

•      Protocols on the CTSU menu

•      Participation in the CTSU

•      Accessing Protocols and Documents

•      Regulatory Support Services

•      Enrolling Patients on CTSU Protocols

•      Reimbursement for Participation

•      Submitting Data for CTSU menu trials

•      Auditing of CTSU Sites

•      Education and Promotion

•      Obtaining Help

Introduction to the CTSU

What is the CTSU?

•      A service of the National Cancer Institute (NCI) that provides clinicians across the United States and Canada access to cancer treatment trials.

 

•      A project funded and directed by the NCI Cancer Therapy Evaluation Program (CTEP) and  operated by Westat and the Coalition of Cancer Cooperative Groups

Goals of the CTSU

•      Provide a wide choice of clinical trial options to the largest possible number of investigators

•      Involve a larger number of treating institutions in the clinical trials process

•      Increase enrollment to cancer clinical trials

•      Streamline or eliminate redundant processes and procedures

•      Provide all necessary support services to make working with the CTSU a positive experience

Protocols on the CTSU Menu

Protocols on the CTSU Menu

•      Developed by the adult cancer Cooperative Groups and other research organizations

 

•      Includes nearly all Phase III treatment trials in breast, gastrointestinal, genitourinary, lung cancers, as well as adult leukemia

 

•      Clinical trials are also offered for gynecological, sarcoma, pancreatic, and other cancer diagnoses

Protocol Sponsors

Participation in the CTSU

Participation in the CTSU

•      Participation is open for members and affiliates of the Cooperative Groups:

      *ACOSOG               *CALGB                 * NCIC CTG                   * ECOG                      * NSABP               * GOG             

      * RTOG                      * NCCTG              * SWOG

 

•      Non-Group aligned sites and investigators may participate as a CTSU Independent Clinical Research Site (CICRS)

CTSU Independent
Clinical Research Sites (CICRS)

 

•      Before non-Group associated physicians can enroll patients, they must meet standards similar to those for Cooperative Group members:

-Credentials must be verified

-Site preparedness must be assessed

 

•      Once qualified by the CICRS Review Committee and contracted with the CTSU they will operate within the CTSU similar to Group members

•      The CICRS Program is opened to new applicants when requested by NCI (the program is currently closed).

 

Qualification Process for CICRS

•      Find more information about the CICRS Program by going to www.ctsu.org

 

•      Click on “Non-Group Investigators” tab

 

 

•      A notice will state whether the program is currently open to new applications.

•      A number of resource documents are available for interested parties.

•      An application will be posted during times when the program is open to applications.

 

CTSU Membership

•      Membership Registration is facilitated by the Cancer Therapy Evaluation Program-Account Management System (CTEP-AMS)

 

•      Still required for all Group investigators who treat patients or prescribe medications

 

•      Now required for all others at site who need access to protocol documents, forms, and educational documents

Purpose of CTEP-AMS

•      To provide a central validation of all staff involved in the conduct of CTEP-sponsored trials

•      To facilitate identification of personnel found on multiple Group rosters

•      To provide future access to other CTEP databases and programs

•      To track/support regulatory compliance for Group Administrators and CTSU regulatory staff

 

Requirements of CTEP-AMS Users

•     Web access

•     A unique, active e-mail address for each user

•     On an annual basis

•   Associates renew registration and confirm contact information

•     As-needed updates to contact information

Steps to CTEP-AMS Registration

•      Register online:  www.ctsu.org

•      Click on the links entitled:

“Register with the CTSU”
“CTEP-AMS registration system” 
“New Registration”

•      Complete the appropriate online registration form by clicking “Yes” or “No” to the question, “Are you a physician?” and by filling in the requested information

•      Await e-mail to confirm user name and password

 

Membership Activation of Investigators

•      A CTSU investigator must be an active member in the NCI-CTEP Database and on at least one Group treatment roster (or be a CICRS participant) in order for membership to be activated

•      The CTSU verifies the physician’s credentials with the NCI and Cooperative Group(s)

 

•      NCI-CTEP and Group databases are dynamic.  Therefore, these credentials are also verified at site registration and patient enrollment

Accessing Protocols and Documents

Obtaining Access to CTSU Protocols

•      Go to http://members.ctsu.org

 

•      Enter your username and

    password

 

 

•      Click on “Protocol” tab

 

•      Search for protocols by cancer type, protocol ID, or key word

Select Specific Documents
and Forms from Member Web Site

•     For each protocol of interest, download:

–  Protocol in full text

–  Amendments

–  Safety updates

–  CRFs

–  AE Forms

–  Education and promotion materials

Submit Protocols to Local IRB

•      Begin this process immediately, based on protocol interest

 

•      Submit protocol, consent forms, and any patient education materials for local IRB approval

 

•      Use “IRB Site Registration Template” as a time-saving tool

–    Not a required form for CTSU

–    Contains pre-prepared answers to most common questions posed by IRBs

–    Prepared for each protocol on the CTSU menu

Regulatory Document Submission into the Regulatory Support System (RSS)

•      Required before patient enrollment

 

 

•      Sites are encouraged to submit site registration forms to the CTSU immediately after local IRB approval is obtained

 

–   Avoid sending protocol-specific regulatory documents at the same time as patient registration documents, as this will delay patient enrollment

Regulatory Support System

Regulatory Support System

Submitting Regulatory Documents

CTSU Central Regulatory Office

1818 Market Street, Suite 1100

Philadelphia, PA 19103

 

Preferred method:

Fax: 215-569-0206

 

The Following Documents Must Be Submitted

•      CTSU IRB Certification Form*

•      CTSU Regulatory Approval Transmittal Sheet*

•      IRB approved consent forms (when required by the lead Group)

•      Protocol-specific regulatory documents (as stated in each protocol)

*all forms are available on the CTSU web site

 

CTSU IRB/Regulatory Approval Transmittal Sheet

•      Required form when submitting regulatory documents for Phase I-III adult trials

 

•      Serves as a fax cover sheet

 

•      Ensures that each regulatory packet is received at the CTSU in its entirety

 

 

CTSU IRB/Regulatory Approval Transmittal Sheet

 

 

CTSU IRB Certification Form

•      Standardized form that captures all data elements required for entry into RSS

 

•      A total of 20 required data elements

–  1-8 may be completed by the site

–  9-20 must be completed by the IRB

 

Responsibility of Sites

1.  Protocol Number

2.  Protocol Version Date (required for amendments)

3.  Protocol Title

4.  Institution Name (s)

5.  NCI Institution Code

6.  OHRP Assurance Number

7.  Principal Investigator

8.  NCI Investigator #

 

Responsibility of IRB

•             Review Type (original, amendment, renewal)

10.  Approval Type (full, expedited, facilitated)

11.  Date of Local IRB Review

12.  IRB Number

13.  Expiration Date

14.  Comments

15 - 20. Signature of IRB official and contact information

 

IRB Certification Form

Timeframe for Regulatory Document Submission

•      Allow 3 business days for regulatory documents to be processed in RSS before checking status on CTSU web site

 

•      The status can be checked on the Members web site (http://members.ctsu.org/) under the RSS tab.  The user can choose to look up RSS Site Registration Status or RSS Site IRB Expiration Status

 

•      Sites should contact CTSU Help Desk if a patient enrollment is imminent

 

Detailed Regulatory Information may be Found at the Following URLs:

•      CTSU RSS Page: http://www.ctsu.org/rss2_page.asp

 

•      RSS Frequently Asked Questions:

    http://www.ctsu.org/RSS_FAQ.asp

 

Enrolling Patients on CTSU Protocols

Ready to Enroll a Patient?

•      Required components prior to patient enrollment:

 

–   Enrolling physician must be registered and credentialed with the CTSU

 

–   All required Site Registration materials must be received and approved by the CTSU

 

–   Patient informed consent must be obtained

 

–   All protocol-specific pretreatment evaluations must be performed

 

–   Eligibility criteria must be satisfied

 

Enrollment Procedure

 

•      FAX the Patient Enrollment Transmittal Form and protocol-specific enrollment forms (Eligibility Checklist and Registration Form) to the CTSU at

    1-888-691-8039

•      The CTSU Registrar Office is open Monday – Friday from 9am – 5:30pm.

 

Enrollment Procedure

•      CTSU Patient Registrars will:

–    Confirm the regulatory requirements are met

–    Verify completeness of faxed enrollment forms

–    Contact sponsoring Group to register the patient

–    Obtain Patient Identification Number and randomization assignment

–    Convey patient ID# and randomization assignment to site

•      For patient enrollments that must be completed within approximately 1 hour, please call the CTSU Cell Phone: 301-704-2376

•      Please use 1-888-462-3009 for ALL other CTSU enrollment-related matters

 

Protocol Implementation

•      Sites should contact the CTSU Help Desk via telephone or e-mail with questions

•   CTSU Help Desk Phone: 1-888-823-5923

•   Email: CTSUContact@westat.com

 

•      Protocol-specific eligibility or treatment questions can be submitted to the Study Chair or Group Operations Office as directed in the protocol

 

 

Reimbursement for Participation

Financial Reimbursement for
Group Members*

•      In most cases, $2,000 per patient enrollment

 

•      Additional $250 for protocols with a cancer control component

 

•      Funds are dispersed from the CTSU to the credited Group (or directly to the site if in the CICRS Program)

 

•      The Group will disperse funds to the clinical site 

    *See following pages for exceptions based on CCOP sites

Credits for Community Clinical Oncology Program (CCOP) Members

•      1 funding/treatment credit for every patient enrollment

 

•      Additional partial credit for trials with a cancer control component

 

•      Funded through the Division of Cancer Prevention (DCP)

 

•      The CTSU will notify DCP of CCOP enrollments on a quarterly basis

Submitting Data through the CTSU

Submitting Clinical Trial Data

•      Instructions are always specified in protocol

 

•      For the majority of studies, data forms (CRFs) are to be submitted to the Group leading the trial, using the methods outlined in the CTSU Logistical Appendix of each protocol document.

                                          

•      The following studies are exceptions, and data should be submitted to the CTSU according to the protocol document:

–    NCIC MA.27 and BR.19, ECOG PACCT-1, NCCTG N0147, and ACOSOG Z1031

 

 

Special Materials Submission

•      Some protocols require collection of special materials

– tumor blocks

– slides

– copies of X-ray films

 

•      Read the protocol and send materials as instructed

Handling Data Queries

•      Queries:

–     are usually generated by and sent to sites by the Lead Group.

–   Query responses should be submitted back to the Lead Group in the manner specified in the query letter or protocol document.

Adverse Event (AE) Reporting

•      Must comply with NCI and U.S. Food and Drug Administration guidelines

 

•      Toxicities are assessed in accordance with NCI Common Toxicity Criteria (CTC) or NCI Common Terminology Criteria for Adverse Events (CTCAE)

 

•      Guidelines are available by clicking on the Adverse Events tab of the CTSU Registered Member Web Site

 

•      Method and timing of report collection and dissemination varies across Groups

 

•      Follow instructions as indicated in the protocol

Auditing of Sites in the CTSU

Audits

•      Will conduct audits of CTSU patients as part of Cooperative Group audits

•      Incorporated into the current audit process by

-CTSU staff augmenting the audit team (if 3 or more enrolled patients)

-Group auditors conduct audit, provided with protocol-specific materials (if less than 3 enrolled patients)

•      Follows guidelines of the Clinical Trials Monitoring Branch (CTMB) of NCI

Education and Promotion

•     Online information about CTSU procedures:

http://members.ctsu.org/Education_Training/

 

» CTSU Process Checklist
(also available on the public web site)
 

 

 

 

» eCOURSE
(also available on the public web site)
 

Education and Promotion

•     Online protocol-specific materials:

 

–  Protocol Card assists with screening

 

 

–  Time and Events gives overview of protocol events

 

 

 

–  PowerPoint Presentations help train research staff

 

–  Physician Fact Sheet offers a summary of treatment plan and patient population with schema on the back, for each protocol

Obtaining Help

Contact the CTSU

•      CTSU Help Desk: 1-888-823-5923

•      E-mail: CTSUcontact@westat.com

•      Business hours: Monday - Friday, 9am – 5:30pm, EST

•      Phones are answered directly

•      When phone lines are busy and on weekends and holidays, voice mailbox is available

•      Message boxes are monitored hourly during business hours.

•      Initial responses to messages made within 2 hours

Resources