Clinical Trials

Overview

Clinical Trial
Participation

Active Clinical
Trials in Canada

CMRG Clinical
Trial Portfolio

Trial Results
and Findings

Clinical Trial
FAQs

Overview

The development of new drugs follows a comprehensive process regulated by Health Canada to ensure the safety and efficacy of treatments before they reach patients. This process moves from early-stage discovery to post-market surveillance, with oversight from agencies like Health Canada’s Pharmaceutical Drugs Directorate (PDD) or Biologic and Radiopharmaceutical Drugs Directorate (BRDD)

1. Discovery and Preclinical Research

Objective: Identify potential drug compounds and assess their safety and biological activity.

Preclinical Research: These are laboratory experiments and animal studies that evaluate the drug’s safety, toxicity, and pharmacological effects. In this phase, researchers gather critical data to understand how the drug behaves in living organisms and its potential benefits. Animal studies are a key component of this phase, providing insight into the drug’s safety profile before human trials.

Outcome: Data from preclinical research is compiled into a Clinical Trial Application (CTA), which must be submitted to Health Canada for review before human trials can begin.

2. Clinical Trial Application (CTA)

Objective: Seek approval from Health Canada to initiate clinical trials.

Contents: The CTA includes all preclinical data, proposed clinical trial protocols, and detailed information on the drug’s composition and manufacturing process. Health Canada reviews the CTA to ensure the trials meet safety standards.

3. Clinical Trials (Phases 0–IV)

Objective: Evaluate the drug in human subjects to assess its safety, efficacy, dosage, and long-term effects (explained in detail below).

4. New Drug Submission (NDS)

Objective: Submit clinical trial results and seek Health Canada’s approval to market the drug.

Contents: The New Drug Submission (NDS) contains the findings from clinical trials, including safety and efficacy data, as well as proposed labeling and manufacturing processes. Health Canada conducts a thorough review of the NDS to ensure the drug’s benefit-risk profile is acceptable.

5. Health Canada Review and Approval

Objective: Health Canada evaluates the NDS and decides whether the drug can be marketed in Canada.

Outcome: If approved, the drug is authorized for public use. Health Canada may request additional studies or information before granting approval.

6. Post-Marketing Surveillance (Phase IV)

Objective: Monitor the drug’s performance and safety after it is on the market. 
Activities: Continued clinical studies, reporting of adverse events, and collection of real-world evidence to track long-term safety and effectiveness. 

Phases of Clinical Trials in Canada

After receiving Health Canada approval, clinical trials in Canada follow a series of phases to rigorously test a drug’s safety and effectiveness:

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Phase 0: Exploratory Trials

Objective: Understand how the drug behaves in the body through microdosing.

Participants: A small number of healthy individuals.

Focus: These early studies gather preliminary data on the drug’s pharmacokinetics (absorption, distribution, metabolism, excretion) and pharmacodynamics (biological effects).

Phase I: Safety and Dosage

Objective: Assess the drug’s safety and determine appropriate dosage levels.

Participants: A small group (typically 20–100) of healthy volunteers or patients.

Focus: This phase is primarily focused on determining safety and identifying side effects, as well as understanding how the drug is processed by the body.

Phase II: Efficacy and Side Effects

Objective: Further evaluate the drug’s effectiveness while continuing to monitor for side effects.

Participants: Several hundred patients with the targeted condition.

Focus: Phase II trials aim to determine whether the drug is effective and continue monitoring for adverse reactions. This phase helps refine dosing and provides early indications of how well the drug works in treating the disease.

Phase III: Confirmatory Trials

Objective: Provide definitive evidence of the drug’s efficacy and safety in a larger population.

Participants: Hundreds to thousands of patients, often across multiple centers in Canada and internationally.

Focus: These large-scale trials confirm the drug’s effectiveness and monitor side effects in a broader patient group. Phase III trials compare the new treatment with existing therapies or placebos and provide data necessary for Health Canada’s approval.

Phase IV: Post-Marketing Surveillance

Objective: Monitor the drug’s long-term safety and effectiveness after it is approved for public use.

Participants: A wide patient population using the drug in real-world settings.

Focus: Phase IV trials gather data on long-term side effects, as well as any rare adverse reactions that may not have been identified during earlier trials. These studies also provide insights into how the drug performs in diverse patient populations over time.

Clinical trials are the backbone of medical advancement, providing the evidence needed to bring new therapies to patients. In Canada, these trials are conducted according to strict regulatory standards, with oversight from Health Canada, institutional review boards (IRBs), and ethics committees.

Clinical trials are crucial for developing treatments for diseases like cancer and multiple myeloma, ensuring that new drugs are not only effective but also safe for patients. By participating in these trials, patients contribute to the advancement of medical science and help bring cutting-edge therapies to market.

Canada’s robust clinical trial framework allows researchers and healthcare providers to deliver innovative therapies that improve patient outcomes while upholding the highest standards of safety and ethical practice.

Clinical Trial Participation

Clinical trial participation plays a critical role in advancing medical research and developing new treatments for diseases like multiple myeloma. By enrolling in a clinical trial, patients contribute to the discovery of innovative therapies while accessing cutting-edge treatments that may not yet be widely available. Here’s what clinical trial participation entails in Canada:

Eligibility Criteria

Every clinical trial has specific eligibility criteria based on factors like age, gender, the type and stage of disease, treatment history, and overall health. These criteria ensure that participants are suitable for the trial and help researchers obtain reliable results.

Potential Benefits

Access to Innovative Therapies: Participants may receive treatments that are not yet available to the public, which could be beneficial in managing or treating their condition.

High-Quality Medical Care: Clinical trial participants are closely monitored by medical experts, often receiving additional care and attention beyond standard

Contribution to Research: Patients play a vital role in advancing medical knowledge and helping future patients by contributing to the development of new therapies.

Informed Consent

Before participating, patients go through an informed consent process, where they receive detailed information about the trial, including its purpose, duration, procedures, potential benefits, risks, and their rights as participants. This ensures that individuals make informed decisions about their participation.

Potential Risks

While clinical trials are carefully regulated, participants may face risks such as experiencing unknown side effects, the new treatment not being effective, or receiving a placebo in some trials.

Phases of Participation

Participants may be involved in one of the various phases of clinical trials (Phase I–IV), depending on the stage of research. Whether testing a drug’s safety (Phase I), its effectiveness (Phase II), or comparing it to standard treatments (Phase III), participants are closely monitored for safety and efficacy.

Support and Oversight

In Canada, clinical trials are subject to rigorous oversight by Health Canada, research ethics boards (REBs), and institutional review boards (IRBs). These bodies ensure that trials are ethical and that participants’ rights and safety are protected throughout the process.

Why Participate?

By choosing to participate in a clinical trial, patients can access potential new treatments and contribute to the improvement of care for others facing similar health challenges. Canadian clinical trials provide a vital pathway for medical advancements, and the contributions of participants help shape the future of healthcare.

If you are interested in joining a clinical trial, your healthcare provider or research organization can help guide you through the process and determine if a trial is right for you.

Active Myeloma Clinical Trials in Canada

You can view active clinical trials in myeloma by visiting the Health Canada website.

CMRG Clinical Trial Portfolio

Current / Active

CMRG 007

A Phase 1/2 Multi-Center, Open Label, Dose Escalation Study to Determine the RP2D, Safety and Efficacy of GSK2857916 in Combination With Pomalidomide and Low-Dose Dexamethasone in Subjects With Relapsed and/or Refractory Multiple Myeloma

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CMRG 008

A Phase 2 Multi-Center, Open Label Study of Isatuximab Added to Standard CyBorD Induction and Lenalidomide Maintenance Treatments in Newly Diagnosed, Transplant Eligible Multiple Myeloma.

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CMRG 010

A Single Arm, Response-adapted, Open Label Study of Iberdomide, Weekly Bortezomib and Dexamethasone (IberBd) With Isatuximab Added on Demand for Transplant-ineligible, Newly Diagnosed Multiple Myeloma Patients

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CMRG 012/EMN30

Phase 3 Study of Teclistamab in Combination With Lenalidomide and Teclistamab Alone Versus Lenalidomide Alone in Participants With Newly Diagnosed Multiple Myeloma as Maintenance Therapy Following Autologous Stem Cell Transplantation

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CMRG 013/EMN28

A Phase 3 Randomized Study Comparing Daratumumab, Bortezomib, Lenalidomide and Dexamethasone (DVRd) Followed by Ciltacabtagene Autoleucel Versus Daratumumab, Bortezomib, Lenalidomide and Dexamethasone (DVRd) Followed by Autologous Stem Cell Transplant (ASCT) in Participants With Newly Diagnosed Multiple Myeloma Who Are Transplant Eligible

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Previous / Closed

CMRG 001

A Phase II Study of Busulfan & Melphalan as Conditioning Regimen for ASCT in Patients Who Received Bortezomib Based Induction for Newly Diagnosed Multiple Myeloma Followed by Lenalidomide Maintenance Until Progression.Content TBD

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CMRG 003

A Single Arm Phase II Study of High-Dose Weekly Carfilzomib Plus Cyclophosphamide and Dexamethasone in the Treatment of Relapsed Multiple Myeloma After 1-3 Prior Therapies

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CMRG 004

A Randomized Phase II, Open Label, Study of Daratumumab, Weekly Low-Dose Oral Dexamethasone and Cyclophosphamide With or Without Pomalidomide in Patients With Relapsed and Refractory Multiple Myeloma

read more

CMRG 006

A Phase 2A Multi Centre, Open Label, Pilot Study Of Pembrolizumab Added to The Standard First-Line Therapy Of Cyclophosphamide, Bortezomib And Dexamethasone (CyBorD) In Newly Diagnosed Multiple Myeloma Patients Not Eligible For Autologous Stem Cell Transplantation

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CMRG 009

A Phase 2 Open Label Study of an Accelerated Infusion Rate of Daratumumab in Patients With Relapsed and Refractory Multiple Myeloma

read more

Trial Results and Findings

Clinical Trial FAQs

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1. What is a clinical trial?

A clinical trial is a research study that evaluates the safety, effectiveness, and potential side effects of new medical treatments, including drugs, therapies, and procedures. Clinical trials are conducted in multiple phases to determine whether new treatments are better than the current standard of care.

2. Why are clinical trials important?

Clinical trials are essential for the development of new treatments for diseases like multiple myeloma. They provide crucial data on how effective and safe a treatment is, and help improve patient care by advancing medical knowledge.

3. What are the phases of a clinical trial?

Clinical trials are divided into four phases:

  • Phase I: Tests the safety of a new treatment in a small group of participants, focusing on dosage and side effects.
  • Phase II: Assesses the treatment’s effectiveness while continuing to monitor safety in a larger group of patients.
  • Phase III: Compares the new treatment to the current standard of care in a larger patient population, looking at both effectiveness and side effects.
  • Phase IV: Occurs after the treatment is approved and marketed, focusing on long-term effects, risks, and benefits.

4. What is the drug development process in Canada?

The drug development process starts with preclinical research, where a potential treatment is tested in the laboratory, including on animals, to evaluate safety before it moves on to human testing. After promising preclinical results, the drug enters clinical trials (Phase I-IV), which are highly regulated by Health Canada to ensure patient safety and the scientific validity of the research.

5. What are the benefits of participating in a clinical trial?

Participants in clinical trials may:

  • Access new and innovative treatments not yet available to the public.
  • Receive close monitoring and high-quality care from research teams.
  • Contribute to medical research that could improve treatment for future patients.

6. Are clinical trials safe?

Clinical trials are designed with strict safety protocols and are overseen by regulatory bodies like Health Canada and independent ethics committees. While all treatments have risks, these risks are closely monitored, and participants are fully informed of potential side effects through the informed consent process.

7. What is informed consent?

Informed consent is the process by which participants are given detailed information about the clinical trial, including its purpose, duration, procedures, risks, and benefits. This allows individuals to make an educated decision about whether to participate in the trial. Participants can withdraw from the trial at any time without penalty.

8. How do I know if I’m eligible for a clinical trial?

Each clinical trial has specific eligibility criteria based on factors such as age, medical history, type of disease, and treatment history. These criteria ensure that the trial’s results are scientifically valid. Your doctor or research team will determine whether you meet these requirements.

9. Can I withdraw from a clinical trial?

Yes, participants can withdraw from a clinical trial at any time, for any reason. Choosing to leave a trial will not affect your standard medical care or your relationship with your healthcare provider.

10. Will I receive a placebo?

In some trials, participants may receive a placebo, especially if there is no existing standard treatment. However, in cancer trials, it’s more common for the new treatment to be compared with the current standard treatment, rather than a placebo.

11. Will I have to pay to participate in a clinical trial?

Typically, participants are not charged for treatments, tests, or procedures that are part of the clinical trial. In many cases, travel expenses or other costs may be covered. The research team will provide details about any costs or compensation.

12. How can I find a clinical trial in Canada?

Your doctor or a research organization can help identify suitable clinical trials. You can also search for trials through platforms like ClinicalTrials.gov or Health Canada’s Clinical Trials Database.

13. What happens after the trial ends?

After a trial ends, the data is carefully analyzed to determine the treatment’s effectiveness and safety. Participants are usually informed of the overall findings, and in some cases, patients may be able to continue receiving the treatment if it has been effective for them. Researchers also share the results with the broader medical community to improve future patient care.

Still have questions?

If you have more questions about clinical trials, feel free to reach out to your healthcare provider or the Canadian Myeloma Research Group for further information.