Description: In “Genetic Therapies for Rare Diseases: Developing Ethical Regulatory Policies,” a commentary published in the Hastings Bioethics Forum, Carolyn Riley Chapman, former lead of the MRCT Center’s Cell and Gene Therapies project, and co-author Nirvan Bhatia argue that the U.S. should adopt a differentiated approval system for gene-based therapies for rare diseases, conferring different tiers of regulatory approval based on different levels of evidence. The authors contend that this approach would improve patient access to innovative therapies while increasing transparency about evidentiary standards and providing stronger incentives for timely post-marketing studies. The MRCT Center’s Toolkit for Supporting the Design and Conduct of Long-Term Follow-Up Studies for Gene Therapies, released in January, offers practical guidance on related challenges in gene therapy research.
What does it take to deploy digital twins and synthetic data in clinical evidence generation — and what do regulators expect when you do?
In this third webinar in the MRCT Center’s Digital Twins and Synthetic Data series, a multidisciplinary panel examines the real-world application of these technologies across the clinical trial lifecycle. The discussion covers evidence quality and validation, regulatory benchmarks, model transparency, and the evolving landscape of FDA and EMA expectations. Panelists draw on experience spanning machine learning, FDA policy development, and drug development leadership to offer practical, grounded perspectives on what adoption looks like today — and where the field is headed.
Topics include:
Defining digital twins and synthetic data: key distinctions and appropriate uses
Reducing control arms and enhancing statistical power in randomized and single-arm trials
Applications across rare disease, oncology, and common conditions
Machine learning vs. traditional statistical approaches: complementary, not competing
Regulatory acceptance: FDA draft guidance, EMA qualification of PROCOVA, and engagement strategies
Model evaluation benchmarks and performance validation across development phases
Cultural and organizational barriers to adoption — and how to address them
Panelists: Daniele Bertolini, Principal Machine Learning Scientist, Unlearn.AI | Tala Fakhouri, VP Consulting AI & Digital Policy and Real World Evidence, Parexel | Karen Smith, Board Director, Context Therapeutics, Skye Bioscience, and Sangamo Therapeutics
Moderator: Barbara Bierer, Faculty Director, MRCT Center
Published in:Journal of Clinical and Translational Science
Abstract: Barbara Bierer and MRCT Center colleagues Walker Morrell, Ava Glazier, and Deborah Zarin, together with Luke Gelinas of Advarra and Tony Tse of the National Institutes of Health, published Characterization of Key Information Sections in Informed Consent Forms Posted on ClinicalTrials.gov in the Journal of Clinical and Translational Science. The 2018 revised Common Rule requires informed consent forms to open with a “concise and focused” key information (KI) section, but provides no guidance on content or format. Analyzing federally funded treatment trial ICFs posted on ClinicalTrials.gov, the authors found that three-quarters included an identifiable KI section averaging one page—yet readability showed little improvement over full ICFs, and a meaningful minority omitted core content such as the main reasons to join or not join a study. The authors call for consensus-based guidelines to help researchers and IRBs develop KI sections that are both compliant and genuinely useful to participants.
Gelinas L, Morrell W, Tse T, Glazier A, Zarin DA, Bierer BE. Characterization of key information sections in informed consent forms posted on ClinicalTrials.gov. Journal of Clinical and Translational Science. 2023;7(1):e185. doi:10.1017/cts.2023.605
Description: Barbara Bierer, Ava Glazier, and Willyanne DeCormier Plosky published “Disclosure of Pregnancy-Related Privacy Risks in Clinical Research Post-Dobbs” in NEJM Evidence. The review examines how routine clinical research practices — such as pregnancy testing, contraception requirements, and incidental pregnancy reporting — have created new privacy risks for participants, clinicians, and investigators following the 2022 Dobbs v. Jackson Women’s Health Organization decision and offers practical guidance for investigators and IRBs navigating this shifting legal landscape.
The MRCT Center held its Annual Symposium on October 22, 2025, hosting 100 people in Boston and 580 people virtually. Sessions focused on concrete implementation challenges in global clinical trials, including how to modernize trial operations, reduce inefficiencies, alleviate site and participant burden, reimagine informed consent as an enabling participant-centered process, and adopt the responsible use of AI. The MRCT Center Long-Term Follow-Up Toolkit was introduced.
John F. Crowley, President & CEO, Biotechnology Innovation Organization (BIO) A call for regulatory modernization, trial simplification, and cross-sector partnership to sustain innovation and expand equitable access to medicines worldwide.
Kevin Bugin (Amgen); Karen Hartman (Mayo Clinic); Bridgette René McCullough (ACIRAH Health); Ann Meeker-O’Connell (Novartis) Practical reforms to reduce protocol complexity and site burden, standardize systems, accelerate start-up, and expand patient access through adaptive and decentralized trial designs.
Sarah White, Executive Director, MRCT Center Repositioning the MRCT Center to remain nimble and opportunistic amid regulatory, technological, and operational uncertainty through focused work on access, innovative trial design, data use and protection, patient-centered approaches, responsive forums, global capacity building, and artificial intelligence.
Michael Cohen-Wolkowiez (Duke University); Megan Doerr (Sage Bionetworks); Cristin Freeman (Bristol Myers Squibb) Real-world applications of AI to enhance informed consent, focusing on participant-centered, scalable, and feasible innovation, while respecting ethical and regulatory expectations.
Willyanne DeCormier Plosky; Sarah White; Sylvia Baedorf Kassis; Lisa Koppelman; Barbara Bierer (MRCT Center) Implementation updates on Representation in Research, capacity building through the TRACE Project, workforce competency standards (JTF), pediatric research, and the European Health Data Space.
Save the date: The 2026 MRCT Center Annual Symposium will take place on Wednesday, October 21, 2026, in Boston. An agenda will be shared in the coming months.
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Across 3 video-based modules, paired with interactive case studies and activities, learners will gain practical, in-depth guidance on providing ethical oversight of health-related research involving human participants. By the end of the course, learners will be able to explain how a Research Ethics Committee (REC) provides oversight from initial review through study closure; articulate why robust Standard Operating Procedures (SOPs) are essential to REC operations; describe the roles and responsibilities of other stakeholders involved in clinical research oversight; and identify methods to assess and strengthen REC operations.
Presented on: October 22, 2025, at the MRCT Center Annual Symposium
Long-Term Follow-Up (LTFU) studies are critical for understanding the long-term safety and risk/benefit profile of innovative cell and gene therapies. Study participants, patients, treating clinicians, companies, regulators, payers, and society-at-large all derive different value from LTFU studies. However, these studies present unique challenges due to their unprecedented duration. For sponsors, they are challenging and expensive to design, conduct, and operationalize. For patients, LTFU participation can be burdensome in terms of time, expense, and opportunity costs.
In this recorded panel, which was held during the MRCT Center’s Annual Symposium in October 2025, Dr. Carolyn Chapman describes the aims of the Center’s LTFU Working Group, which was launched in September 2024 and benefited from the perspectives of 25 members from outside the Center. Dr. Chapman also previews the release of the LTFU Toolkit, which was collaboratively developed by the Working Group. The Toolkit offers practical guidance to support best practices for LTFU studies for both investigational and approved gene therapies.
In this session, Dr. Chapman leads a discussion with three distinguished industry leaders on a variety of issues addressed in the LTFU Toolkit. These include integrating decentralized elements to reduce burden, refining endpoint selection, harmonizing data for interoperability across LTFU studies, and minimizing loss to follow-up through participant engagement and clear communication. They also highlight the need for flexibility in LTFU study designs to meet evolving patient needs, and the importance of keeping new and current participants informed about protocol changes and any key findings. Looking ahead, the group calls for ongoing dialogue on data harmonization and sharing, results transparency, and innovative approaches to streamline the collection of long-term safety information.
𝗠𝗼𝗱𝗲𝗿𝗮𝘁𝗼𝗿: Carolyn Riley Chapman, PhD, MS – Lead Investigator, Brigham and Women’s Hospital; Member of the Faculty, Harvard Medical School
Panelists:
Pamela Tenaerts, MD, MBA, Chief Medical Officer, Medable
Long-term follow-up (LTFU) studies of gene therapy (GT) recipients are crucial for understanding the overall benefit-risk profile of these innovative products. However, LTFU studies are challenging to design, conduct, and execute, and pose significant burdens on both patients and sponsors.
The MRCT Center CGT Toolkit is comprehensive and provides background information, practical resources, and recommendations to support best practices for LTFU studies for both investigational and approved gene therapies—balancing the generation of critical long-term safety and efficacy data with the need to reduce burdens placed on participants, caregivers, sponsors, and investigators.
Compared to the draft version, the updated Toolkit v2.0 includes two new resources, an Executive Summary and a Patient Resource, which have also been released as standalone versions. Additions included new and/or revised charts, tables, and resources. The Toolkit explores ideas for how LTFU studies could be improved in the future, raising questions that the field should discuss and address.
The Toolkit enables easy navigation to various sections and subsections via multiple clickable, interactive toolbars. The sections are as follows, with the core elements in bold font:
The Toolkit incorporates several interactive features designed to support intuitive navigation and ease of use:
Clickable Table of Contents for rapid access to major sections and subsections.
Right-hand vertical navigation bar on every page, enabling quick movement between tools within the document.
Interactive table of LTFU study types, mirrored by color-coded tabs that remain clickable throughout the associated pages.
Secondary navigation bar at the top of each page within the Considerations & Recommendations section. This feature highlights your location within the nine subsections, allows you to jump directly between subsections by clicking the dots, and includes a grey diamond icon that returns you to the full list of subsections.
