Impact of COVID-19 Pandemic Declaration on New Oncology Trial Commencements: An Interrupted Time Series with Segmented Regression Analysis

Abstract

This study aimed to assess the trend in oncology trial commencements registered on ClinicalTrials.gov and to evaluate the contributing factors by comparing the trends in the pre- and post-COVID-19 pandemic era. The ClinicalTrials.gov database was searched to identify oncology study trials starting from 1 January 2018 to 28 February 2021. Data on the variables of start/complete date, phase, status, funding source, center, country and study type were extracted. According to the time point of the COVID-19 pandemic declaration by the World Health Organization (WHO), March 2020, we analyzed the extracted data, including interrupted time series (ITS) analysis and multivariable regression analysis. We identified 18,561 new oncology trials during the study period. A total of 5678 oncology trials in the prepandemic period and 6134 in the postpandemic period were included in the comparative analysis. The year 2020 had the most newly launched trials (32.3%), and the majority of trials were planned to be conducted for longer than two years (70.3%). The results of ITS show the trend in the commencement of oncology trials was significantly increased after the pandemic declaration (coefficient = 27.99; 95% CI = 19.27 to 36.71). Drug intervention trials were the largest contributor to the increased trial number compared to different interventions, such as trials of devices or procedures (OR = 1.14; 95% CI = 1.03 to 1.26, OR = 1.09; 95% CI = 0.91 to 1.29, and OR = 1.12; 95% CI = 0.96 to 1.31, respectively), whereas the United Kingdom was the highest contributor to the number of decreased trials (OR = 0.67; 95% CI = 0.51 to 0.89 p = 0.01) in the postpandemic era. The interruption in oncology trial initiation was diminished shortly after the COVID-19 pandemic declaration, which was influenced by several factors, such as interventions or national responses. Based on the current outcomes, appropriate strategies for developing oncology trials can be planned to mitigate the impact of future crises on oncology trials.

Keywords: COVID-19; clinicaltrial.gov; oncology; pandemic.

Figure 1

Flow chart of trial selecting oncology trials.

Figure 2

Monthly trends in the commencement of new oncology trials from 1 January 2018 to 28 February 2021.

Figure 3

Monthly trends in the commencement of new oncology trials according to countries from 2018 to 2020. (a) United States; (b) China; (c) France; (d) Canada; (e) Italy; (f) United Kingdom; and (g) Korea.

Figure 3

Monthly trends in the commencement of new oncology trials according to countries from 2018 to 2020. (a) United States; (b) China; (c) France; (d) Canada; (e) Italy; (f) United Kingdom; and (g) Korea.

Figure 3

Monthly trends in the commencement of new oncology trials according to countries from 2018 to 2020. (a) United States; (b) China; (c) France; (d) Canada; (e) Italy; (f) United Kingdom; and (g) Korea.

Figure 4

Monthly trends in the commencement of new oncology trials according to funding source from 2018 to 2020. (a) Industry; (b) government; (c) other; (d) academia; and (e) cofunded.

Figure 4

Monthly trends in the commencement of new oncology trials according to funding source from 2018 to 2020. (a) Industry; (b) government; (c) other; (d) academia; and (e) cofunded.

Figure 5

Monthly trends in the commencement of new oncology trials according to type of interventions from 2018 to 2020. (a) Drug; (b) device; and (c) procedure.