"I think it's been met with a shrug:" Oncologists' views toward and experiences with Right-to-Try.

BACKGROUND The federal Right-to-Try (RTT) Act created an alternate regulatory pathway for preapproval access to investigational drugs. A few studies have examined the experiences of physicians with Food and Drug Administration's Expanded Access Programs (EAP), but no study has yet to examine their attitudes and experiences toward RTT. METHODS This study explored the views of 21 oncologists at a major cancer center with 3 main sites across the U.S. using semi-structured interviews and qualitative analysis. Participants were selected to have experience with EAP. RESULTS Most oncologists had limited familiarity with RTT and several reported confusion about the legislation, including whether patients have a right to investigational drugs and an obligation for companies to provide them. While oncologists were interested in decreased regulatory burdens, three areas of concern were articulated: lack of safety and oversight; unclear structure and no provision for data collection; and potential heightening of patient expectations. Only four oncologists had experience discussing RTT and none formally attempted to obtain the drug through this mechanism. Participants questioned the practicality of RTT legislation and suggested alternative ways to improve access. CONCLUSIONS The study provides foundational empirical data underlying challenging ambiguities by experienced oncologists familiar with off-trial use of investigational therapeutics and reaffirms the role of physicians and regulatory bodies in mitigating the risks of investigational drugs. Our findings highlight the need for medical centers to inform oncologists about RTT and other preapproval pathways so that they are able to address questions from patients interested in non-trial investigational drugs.