By Shannon Pettypiece,  The U.S. government’s cancer research network is “approaching a state of crisis” as waste and inefficiency cause 40 percent of late-stage trials it funds to be abandoned before completion, a report found.

The government-funded National Cancer Institute’s clinical trials group isn’t able to effectively study the benefits of new and current treatments, according to the analysis by the Institute of Medicine. Among the report’s recommendations is increasing funding for cancer studies, simplifying the process of designing trials, and offering incentives for doctors to do such research.

The NCI’s network of cancer centers and doctors tests cancer treatments on 25,000 patients a year, with an annual budget of about $145 million, the report said. Cancer kills about 560,000 people in the U.S. each year, the second-biggest cause of death behind heart disease, according to the Centers for Disease Control and Prevention in Atlanta.

“If the clinical trial system does not improve its efficiency and effectiveness, the introduction of new treatments for cancer will be delayed and patient lives will be lost unnecessarily,” the report said.

The trial network, called the Clinical Trials Cooperative Group Program, is comprised of doctors at universities and community cancer centers who develop clinical trials and enroll patients in those studies. Its work fills a research gap by focusing on efforts not typically undertaken by drug companies, such as comparing rival treatments or testing combinations of experimental therapies.

The process for carrying out those trials has become too complex and can take more than two years to design and initiate clinical trials, the report said.

 ‘Important Contribution’

“The cooperative groups have made a very important contribution that individual drug companies might not have made,” said John Mendelsohn, president of the University of Texas M.D. Anderson Cancer Center and chair of the committee that did the report. “We would lose something very important if the cooperative groups faded.”

The Institute recommended the NCI consolidate administrative operations, streamline government oversight of clinical trials, develop more efficient trial design, and create incentives for investigators to participate in studies. Health insurers should also pay for the cost of non-experimental care that is part of the clinical trial, such as additional scans, lab tests and physician visits.

The report was conducted at the request of the NCI director John Niederhuber. The Institute of Medicine is part of the National Academy of Science, a non-profit organization that acts as an adviser to the federal government.