For many years, the research community has been a small, yet relentless, arm of interventional radiology. Many IRs who would like to have participated in trials and studies, however, have found the entry into research to be daunting.
“We need to prove our procedures are effective and safe, and we need quality studies in order to do so,” said Jeremy C. Durack, MD, MS, FSIR. But research education and knowledge are difficult to acquire, he says, and finding funding, sites and support resources can be even harder. This, in turn, makes it difficult to produce rigorous scientific investigation that provides evidence supporting the efficacy of IR therapies.
“My research learning curve was steep,” said Suresh Vedantham, MD, FSIR. “There wasn’t an easy way to start, and most of my mentors came from outside of IR. We need to change that. We want to make the clinical research learning curve as easy as it can be.”
Part of the answer may lie in the new IR Clinical Trials Network (IR CTN). Designed to create, promote and facilitate the development of clinical trials, the IR CTN is part of ongoing efforts to cultivate a culture of research in IR.
“The mission of the IR CTN is to enhance rigorous scientific investigation into new IR techniques, devices, practice models and innovative procedures to improve patient outcomes and access to care,” said Sanjay Misra, MD, FSIR. Dr. Misra, along with Drs. Vedantham, Durack, and Katharine L. Krol, MD, FSIR, has been one of the guiding forces behind the IR CTN. Dr. Misra has worked with SIR Foundation for the past 2 years to bring the network to life after realizing how underrepresented IR is, both in terms of clinical networks and in the general awareness of those on review panels at organizations such as the National Institutes of Health (NIH).
“The concept for a framework to increase quality and volume of IR research has been around for many years,” said Dr. Durack. “Then came Dr. Misra and his idea for this network. He is a standout researcher and has interacted with countless other societies, funding organizations and the NIH. He’s highly aware of the CTNs that other specialties have, as well as the need for one in IR.”
Though there are a number of tangible benefits to joining the IR CTN, the main goal is bringing researchers together.
Sajay Misra, MD, FSIR, presents on the IR CTN at SIR 2022.
“Central to accomplishing the mission of the IR CTN is the establishment of a robust community that enables ongoing education and mentorship of developing IR investigators, guidance on preparation of clinical trial grant applications, sharing of best practices in clinical trial conduct, and identification of participating sites for clinical studies,” said Dr. Misra. “I’m confident that the IR CTN will help our community achieve all these goals and more.”
What are the benefits?
The aim of the network, organizers say, is providing access to many of the elements that make research feel possible, such as a network of capable enrollment sites and education and guidance on trial design and implementation skills.
“SIR Connect, since its inception, has been a fertile ground for communication between members,” said Dr. Durack. “That kind of communication is what we’d like to encourage with the CTN. We want to provide forums for discussion, where researchers can collaborate and benefit from the experience of others.”
These discussion forums, Dr. Durack says, will be crucial in changing the perception of how accessible research can be.
“If we have a community where IRs and stakeholders can communicate, share best practices and identify other collaborators, it will hopefully create the kind of shared learning that will enable IRs to elevate their abilities,” said Dr. Vedantham.
This network will be particularly important for those looking to create investigator-initiated studies.
“Many researchers in IR have participated in industry-led trials,” said Dr. Vedantham. “We test devices and see if they merit FDA approval. That’s very different from having an IR generate the hypothesis and protocol and launch a trial with no commercial intent.”
However, Dr. Vedantham stresses that these resources aren’t only for those conducting large-scale investigator-led studies.
“We want to see smaller studies,” he said. “These studies yield helpful data, help investigators learn to conduct trials from start to finish, and provide them with the data, experience and networks to apply to larger scale studies.”
The network is open to all IRs, organizers say, regardless of practice type.
“I encourage private practice to get involved, as the data from your practices is crucial to the science of our specialty,” said Dr. Krol. “And for private practices, getting involved in clinical trials can elevate your status with your hospital administration, your patients, your referring physicians and other constituents. It can be a new line for referrals to your practice.”
There is nothing more satisfying than being able to pass on your hard-earned knowledge.
Jeremy C. Durack, MD, FSIR
There is also interest in utilizing the network as a resource to elevate the capabilities and attractiveness of IR-led clinical studies that are seeking funding or other support from government agencies, foundations and industry, according to Dr. Vedantham.
Will it build connections with industry?
According to organizers, there are multiple benefits for industry and corporate partners who join the network.
“They will have access to an established network of participating sites for trial concepts, expert level perspectives on research needs and opportunities in the IR community, and access to clinically engaged IRs,” Dr. Misra said.
“Collaboration with industry is central to our industry,” Dr. Durack said. “When industry partners feel more engaged with the IR community, they feel like their voice is heard, and they can contribute ideas or research to registries.”
They are also often more willing to fund studies, he said, because they understand the data will serve their purposes as well as the investigator’s.
“I have found it’s very important to be in touch with what is happening in industry and clinical research organizations (CROs), as they’re often employing the most modern ways of implementing studies—which we may not hear about otherwise,” said Dr. Vedantham. “There are areas of academia that lag behind what’s happening in industry, so engaging with them can yield valuable insights into how to most effectively advance a research agenda. Clinical trials are challenging—often we need an ‘all-hands-on-deck’ approach to succeed.”
Is research experience necessary to join?
There is no barrier to entry or expected level of research experience for those interested in joining, organizers say.
“This is open to pretty much any IR interested in studying and investigating,” said Dr. Vedantham. “We want to bring in younger IRs, because the earlier people elevate their insight and knowledge, the better set up they are for success. And the more motivated they become.”
This opportunity for mentorship is one of the most exciting benefits of the network, according to Drs. Vedantham and Durack.
“There is nothing more satisfying than being able to pass along your hard-won knowledge,” said Dr. Durack. “Even for those IRs who have more research experience, being part of the IR CTN is worth it just to be able to pass on your own education.”
“Mentorship is absolutely an area where we can do more,” said Dr. Vedantham. “We have a lot of people who have accomplished so much in our field. The IR CTN aspires to help them pass along their expertise and lessons learned to other IRs, beyond the individual relationships at their own institutions.”
Expanding the reach of IR research
Another benefit of the network lies in the ability to bring IRs across the nation together.
“What this offers most of all is community,” said Dr. Vedantham. “SIR and SIR Foundation have been such effective connecting vehicles. By putting that energy behind the IR CTN, we now have the ability for a potential researcher on the West coast to connect with a researcher in the Midwest with a niche specialization in that topic.”
It also opens up research resources and opportunities to facilities in traditional IR deserts. Not only will access to resources elevate the practices in these areas, it will also ensure that future IR research is capturing patients from different socioeconomic backgrounds.
“This is a member benefit that will have far-reaching effects for every practicing IR and all of our patients, including data that facilitates clinical decision-making, as well as providing access to IR services by supporting payment and coverage of IR services,” said Dr. Krol.
“It is imperative that we fund innovative research to help solve unique medical issues. What better way to do that than by working together?” Dr. Misra said. “Remember, this collaboration will allow us to capture data from all facets of clinical trials, with which we can adjust standards and guidelines. Guidelines can then help change reimbursement rates, and we can all go home feeling a bit happier and proud of ourselves.”
“This is a milestone in the building of a culture of research in IR,” said Dr. Krol.
Help SIR Foundation grow our network! If you are an academic or private practice investigator and are interested in participating in the IR CTN, please take this brief survey.
If you are an industry or corporate representative and are interested in participating in the IR CTN, please take this brief survey.
Interested in joining the IR Clinical Trials Network? Visit SIR Foundation at bit.ly/3aDOyZh. For more information on the IR CTN and how to join, please contact SIR Foundation Director of Clinical Research and Grants Pooja Dosh at pdoshi@sirweb.org.
