Many oncology programs start strong. The study kick-off goes well, early enrollment meets expectations, and all the while, teams are aligned. Decisions move quickly, and the program begins to expand. This involves more sites, additional cohorts, new regions, and then something changes. The issue isn’t growth, but the exponentially increasing complexity that comes with scale.
Understanding the Changes as Programs Scale
Scaling introduces more than volume. It introduces more people, more interfaces, more handoffs, and more decisions that need coordination across functions and geographies. What once felt efficient becomes harder and harder to sustain; not because the team is doing anything wrong, but because the operating model was never designed to handle the added intricacies.
This is where many oncology programs feel a shift. Team members turn over, communication breaks down, and alignment requires more effort. Often, a decision that was once reached in a single conversation now involves a chain of stakeholders and associated bottlenecks.
How Complexity Shows Up in Practice
Complexity rarely manifests as a single dramatic event. It appears gradually, through subtle, small changes that are easy to rationalize in the moment:
- Handoffs increase across vendors, functions, and regions
- Different parts of the team operate with different baseline assumptions
- Re-establishing alignment becomes a repeated task, rather than maintaining it
- The same issue is addressed multiple times in different places, increasing inefficiency
As complexity increases without clear management initiatives, programs become harder to run, even as science advances.
When Scaling Starts To Feel Like Rework
This is the point sponsors often describe as feeling like they’re starting over. Teams spend time reclarifying roles, re aligning expectations, and re establishing context that already existed earlier in the program. The result is slowed progress, not because the program is failing, but because momentum wasn’t designed to carry forward smoothly through expansion. Scaling a program shouldn’t feel like resetting it; for many oncology sponsors, unfortunately, it does.
The Practical Takeaway
The oncology programs that scale successfully and seamlessly don’t wait for complexity to force a redesign. Instead, they anticipate it by treating scaling as an operating model, rather than just a resourcing question. For these programs, continuity is planned early and maintained as new sites, regions, and stakeholders come online.
When continuity holds, teams spend less time coordinating the work and more time advancing the therapy. That matters because delays at scale ultimately affect how quickly patients gain access to the treatments upon which their lives depend.
Continue the Conversation
Attending this year’s ASCO Annual Meeting? Meet with our team of experts to continue the conversation on scaling your oncology development and learn how we can meet your needs. Book a meeting today.
