John Smith

Increasingly, trials exist in a very competitive environment, where multiple trials are vying for a limited pool of potential participants. This is especially true of cancer and cardiology trials. It has become necessary for trial directors to view recruitment as a marketing effort, just as one would market a product or a service. They must focus on the positioning and messaging that differentiates the trial and the compound being studied from other compounds currently in testing or on the market.

Public relations has become an important part of the recruitment and enrollment effort for clinical trials. Unlike advertising's "paid" media, PR has the credibility of "earned" media. PR is also far less expensive than advertising. A broader and richer strategy featuring a range of tactics and channels that stretch beyond newspapers and magazines, public relations is able to not only educate patients but also alert them to the existence and benefits of trials. And the Internet, a valuable PR tool that has been growing in use and reach, provides a host of specialty sites that channel information and news regarding medical information to people interested in specific topics.

Recently, a Manning, Selvage & Lee client, a large biotechnology company in Cambridge, needed to recruit patients with bronchioloalveolar cancer (BAC) for a Phase II clinical trial. BAC is a relatively rare subtype of non-small cell lung cancer (NSCLC); it makes up about 20 percent of the NSCLC patient population—or about 30,000 patients.

Unfortunately, in addition to being rare, BAC is also frequently misdiagnosed. It has a unique "masked" presentation, it frequently strikes non-smokers and other low-risk populations, and is often mistaken for pneumonia or other inflammatory conditions of the lung—at least until antibiotics and other treatments fail.

Taken together, these factors increased the difficulty of recruiting patients for the BAC trial.

This particular recruitment effort was focused on five larger markets—Boston, Seattle, New York, Chicago, and Atlanta—with principal investigators already in place, a presumably larger patient pool, and plenty of traditional media providing recruiting opportunities. Interestingly, as we developed the PR side of the recruiting effort, we found that the most effective and efficient way to reach our target audiences was online through a variety of Internet sites and channels—listservs, blogs, and chat rooms, as well as patient advocacy sites.

BAC on the Web

With the knowledge that much of our outreach was going to be conducted online, we developed an informational Web site to use in recruitment efforts. The site itself was rudimentary—a simple single page that contained the same information as the print flier for the trial. But, the benefit of the Web site was that we were able to change the information as needed. For example, when the protocol changed mid-trial, we were able to reflect those changes immediately, while the fliers that had already been distributed continued to contain the outdated information.

We found that many Web sites we were interested in—including local chapters of the American Cancer Society and Gilda's Club—were unwilling or unable to post direct links or direct information about one particular clinical trial. There were, however, some Web sites created explicitly for this purpose, including NexCura and the clinical trials pages of the National Cancer Institute. Most patient-focused Web sites were more than willing to link to these clearinghouse sites.