ArticleUrologic oncology2021
Estimating the rate and reasons of clinical trial failure in urologic oncology.
Article in Urologic oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed.
- Early termination of clinical trials enrolling patients with breast cancer: Reasons, determinants, and temporal patterns.Breast (Edinburgh, Scotland) · 2026Article
- Two decades of kidney stone interventional trials on clinicaltrials.gov: a registry-based landscape analysis of design, endpoints, and dissemination.Urolithiasis · 2026Article
- Approaches in analyzing predictors of trial failure: a scoping review and meta-epidemiological study.BMC medical research methodology · 2026Article
- Rationale and protocol for a prospective clinical trial enrollment improvement hybrid study within a trial.Contemporary clinical trials communications · 2025Article
- Characteristics and potential predictors of prematurely terminated interventional clinical trials for ovarian cancer in the ClinicalTrials.gov database.BMC cancer · 2025Article
- Determinants of clinical trial failure in multiple sclerosis: insights from ClinicalTrials.gov.Research square · 2025Article
- Large Language Models in Randomized Controlled Trials Design: Observational Study.Journal of medical Internet research · 2025Observational
- Exploring the connection between EU-funded research and methodological approaches: insights from a retrospective analysis.Journal of translational medicine · 2024Article
- Estimating the Size and Scope of the Urologic Oncology Clinical Trials Enterprise.Urology practice · 2024Article
- Microfluidic-based human prostate-cancer-on-chip.Frontiers in bioengineering and biotechnology · 2024Article
- Early Termination of Oncology Clinical Trials in the United States.Cancer medicine · 2023Article
- Interventions to improve access to clinical trials in urologic oncology.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2023Article
- Access to urologists for participation in research: An analysis of NCI's Community Oncology Research Program landscape survey.Contemporary clinical trials communications · 2022Article
- Article
- Prostate cancer clinical trial completion: The role of geography.Contemporary clinical trials · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
Abstract
objectivesClinical trials are pillars of modern clinical evidence generation. However, the clinical trial enterprise can be inefficient, and trials often fail before their planned endpoint is reached. We sought to estimate how often urologic oncology trials fail, why trials fail, and associations with trial failure.
methodsWe queried phase 2/3 urologic clinical trial data from ClinicalTrials.gov registered between 2007 and 2019, with status marked as active, completed, or terminated. We extracted relevant trial data, including anticipated and actual accrual, from trial records and ClinicalTrials.gov archives. We manually coded reasons given in the "why stopped" free text field for trial failure into categories (poor accrual, interim results, toxicity/adverse events, study agent unavailable, canceled by the sponsor, inadequate budget, logistics, trial no longer needed, principal investigator left, no reason given, or other). We considered trials terminated for safety or efficacy to be completed trials. Trials marked as terminated for other reasons were considered failed trials. We then estimated the rate of trial failure using competing risks methods. Finally, we assessed associations with trial failure using a Cox proportional hazards model.
resultsA total of 1,869 urologic oncology trials were included. Of these, 225 (12.0%) failed, and 51 (2.7%) were terminated for "good" reasons (e.g., toxicity, efficacy). Of the 225 failed trials, 122 (54%) failed due to poor accrual. Failed trials had a lower anticipated accrual than successfully completed trials (55 vs. 63 patients, P<0.001). A total of 6,832 patients were actually accrued to failed trials. The 10-year estimated risk of trial failure was 17% (95% CI 15%-22%). Single center trials, phase 3 trials, drug trials, and trials with exclusively USA sites were more likely to fail.
conclusionWe estimate that 17%, or roughly 1 in 6, of urologic oncology trials fail, most frequently for poor accrual. Further investigations are needed into systemic, trial, and site-specific factors that may impact accrual and successful trial completion.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.