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Types and Phases of Clinical Trials

By Lynne Eldridge MD, About.com

Updated July 27, 2009

About.com Health's Disease and Condition content is reviewed by the Medical Review Board

Clinical trials are divided into types: The kind of question the study is designed to answer, and phases, or how far along a treatment is in the investigative process.

Types of Clinical Trials:

We often think of clinical trials as a method of studying new drugs, but many different types of trials are in process to evaluate lung cancer.

  • Prevention trials – Prevention trials look at substances and lifestyle factors that may raise or lower the risk of developing lung cancer
  • Screening trials – Screening trials study methods to diagnose cancer in its early stages when it is often more curable
  • Diagnostic trials – Diagnostic trials are done to look for the best methods of finding out if a person has cancer, or to accurately determine the stage of cancer that is present.
  • Treatment trials – Treatment trials evaluate the ability of drugs, radiation, surgery, or other measures to treat cancer.
  • Supportive care trials – Supportive care trials are also called quality-of-life trials. They study the ability of a drug or procedure to lessen the symptoms of cancer or symptoms related to the treatment of cancer

Phases of Clinical Trials

Clinical trials are done to determine the safety and effectiveness of a new drug or procedure in people. During this process, the treatment goes through “phases,” beginning with the first use in people through approval for general use by the Federal Drug Administration (FDA).

Phase 1 clinical trials – Is the treatment safe?

After an experimental drug or treatment has been tested in the lab and/or on animals, it enters a phase 1 trial. These trials involve a small number of patients to test safety in humans and determine the correct dose of a drug. These trials also help determine the best way to give the drug, whether oral or intravenously.

Phase 2 clinical trials – Does the treatment work?

After determining that a treatment is reasonably safe in people, it enters phase 2 trials. These are done to test for effectiveness – does the treatment work? Since a larger number of people are studied, further information is gained on safety during phase 2 trials.

Phase 3 clinical trials – Does the new treatment work better than the standard treatment?

Phase 3 trials test the new drug or treatment on hundreds or thousands of individuals. These studies are often “double-blind” trials, which mean that neither the patient nor the investigator knows which treatment is being used. They are designed to answer the question of whether or not the new treatment works better, or has fewer side effects, than the standard treatment.

Phase 4 clinical trials – Is the treatment safe over time?

Phase 4 trials are less common and serve to answer questions after the FDA has already approved a drug for general use. These can address questions such as long-term safety of a drug, or other circumstances in which the drug may be helpful.

Sources:

National Cancer Institute. Clinical Trials. Updated 05/19/06. http://www.cancer.gov/cancertopics/factsheet/information/clinical-trials

American Cancer Society. Clinical Trials. What you need to know. Updated 05/30/08. http://www.cancer.org/docroot/ETO/content/ETO_6_3_Clinical_Trials_-_Patient_Participation.asp

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