Moore School of business professor Sanjay Ahire used operations research to improve cancer clinical trials selection at the Medical University of South Carolina.

Every cancer clinical trial represents an opportunity to advance treatment and provide hope for patients, but determining which trials to pursue requires a careful balance of scientific promise, patient needs, available resources and the ability to successfully enroll participants.

A collaboration between the University of South Carolina’s Darla Moore School of Business and the Medical University of South Carolina’s (MUSC) Hollings Cancer Center is helping transform how those decisions are made. Through operations research and process improvement methods, Dr. Sanjay Ahire (Professor of Operations and Supply Chain Management and Co-Director, USC Operations and Supply Chain Center) developed a decision support framework designed to help Hollings Cancer Center identify and prioritize clinical trials with the greatest potential impact for patients. The work was recently published in INFORMS Journal on Applied Analytics, the flagship applied research journal of the Institute for Operations Research and Management Science (https://pubsonline.informs.org/doi/10.1287/inte.2025.0202).

The collaborative project was conducted through the Moore School’s Operations and Supply Chain Center (OSC) Capstone Consulting Projects program, bringing together business students, healthcare professionals, physicians, researchers and administrators to address a complex challenge of ensuring limited resources are directed toward the clinical trials most likely to benefit patients.

The collaboration began in 2021 when MUSC joined the Moore School’s Operations and Supply Chain Center to participate in MGSC 497 Capstone Consulting Projects. Among several process improvement initiatives, the cancer clinical trials selection project became one of the most meaningful efforts.

“The goal was to develop a decision support process and tool to help prioritize the most important clinical trials, those that are clinically important and with high patient accrual potential,” Ahire says.

The project required extensive collaboration across disciplines. The team worked closely with Hollings Cancer Center leadership, physicians, surgeons, nurses, research teams and administrative staff to understand the complexities involved in selecting and implementing cancer clinical trials.

According to Patrick A. Flume, M.D., Associate Vice President for Clinical Research at MUSC and Director of the MUSC Cystic Fibrosis Center, Ahire’s ability to bring together diverse perspectives was instrumental to the project’s success.

“Dr. Ahire demonstrated his skills in deconstructing complicated interdisciplinary and interdepartmental processes,” Flume wrote. “He communicated clearly and competently, understanding the intricacies of technical perspectives of domain experts while also nudging them to think holistically about the entire process.”

Selecting clinical trials is a complex process. While every study has the potential to advance cancer treatment, healthcare organizations must carefully consider how to allocate limited resources, including staffing, funding and patient recruitment capabilities.

“When we are dealing with improving a process to help highly qualified subject matter experts such as cancer surgeons and researchers, the challenge is to arrive at a holistically selected overall mix of clinical trials that utilize a Cancer Center’s technical, human, and financial resources in the most effective manner,” Ahire says.

To address this challenge, the team developed a comprehensive prioritization framework using more than 15 criteria, including clinical importance, patient recruitment potential, administrative workload, technical complexity and regional cancer trends.

The framework incorporated input from physicians, nurses, Hollings Cancer Center leadership, peer cancer centers around the country and epidemiological analyses of cancer needs in and around South Carolina. This allowed the team to create a structured approach for evaluating clinical trials based on both scientific value and practical considerations.

“The hallmark of the project was systematic and detailed inputs from physicians, nurses and administrators to identify relevant criteria, develop weights for these criteria and construct rating scales for cancer trials based on customized considerations for each criterion,” Flume wrote.

The result was a science-based tool that allowed Hollings Cancer Center to compare clinical trials more consistently and strategically.

The impact of the framework extended beyond improving internal processes. It helped ensure patients had greater access to the trials most likely to make a difference.

Ahire says that before implementation, some high potential trials were overlooked while others were pursued despite challenges related to patient recruitment or resource demands. After implementation, Hollings Cancer Center saw measurable improvements.

The results were significant. The percentage of trials selected decreased from 26% to 17%, while the percentage of selected trials meeting or exceeding patient accrual targets nearly doubled, increasing from 20% to 39%.

“These are clear indicators that a larger number of patients who needed clinical trials most were able to gain access to those trials,” Ahire says.

Flume emphasized that the framework strengthened Hollings Cancer Center’s ability to select impactful trials.

“We have integrated the comprehensive framework developed by Dr. Ahire into our cancer trials prioritization and selection process,” Flume wrote. “We thank Dr. Ahire for his contributions to improving our capabilities for selecting impactful trials.”

Beyond its impact on healthcare, the project provided Moore School students with an opportunity to apply business skills to a critical real-world challenge. The student consulting team (Tania Harbuz, Yaru Li, Madison McLeod, Avery Ridout and Luke Spalding) worked directly with MUSC stakeholders while earning the Sonoco-USC Lean Six Sigma Green Belt certification.

Because the project took place during COVID-19, students completed the engagement entirely remotely through Zoom meetings and virtual collaboration, developing communication, project management and consulting skills in a unique environment.

“Direct benefit included the opportunity to work on a real, live, and meaningful process improvement consulting engagement, leading to the unique Sonoco-USC Lean Six Sigma Green Belt certification. Students also conducted the entire project remotely via Zoom and email,” Ahire says. “More importantly, this placed the students at a competitive advantage in the job market, and students communicated a transformation in their perspective because of this project.”

Students entered the project expecting to improve a typical business process but left with firsthand experience applying those concepts to a critical healthcare challenge. By the conclusion, they were discussing complex cancer research trial processes, communicating with physicians and presenting recommendations to healthcare leaders.

“I witnessed their transformation from skepticism to active focus to passion as they realized the potential of their project to actually save lives,” Ahire says.

The success of the Hollings Cancer Center collaboration demonstrates the power of combining business expertise with healthcare innovation. Ahire believes the framework has applications beyond MUSC and could benefit cancer centers and healthcare organizations nationwide.

“The comprehensive nature of the assessment framework and validation by MUSC/Hollings Cancer Center leadership have increased the credibility of the tool,” Ahire says. “The methodology should also be useful in research and development settings, including pharmaceutical companies prioritizing clinical trials.”

The team plans to share its findings with other cancer research centers, national healthcare organizations and industry partners.

For Ahire, the project represents one of the most meaningful collaborations of his career.

“Among the 250+ projects I have done over almost 30 years, this is one of the most meaningful,” Ahire says. “It gives me the highest level of personal and professional fulfillment when I can use my expertise in operations research and process improvement to help medical professionals and organizations serve their patient population more effectively and efficiently.”

Ultimately, the project highlights what can happen when business knowledge is applied beyond traditional industries, using analytics, collaboration and innovation to help improve lives.

“The paper represents a relatively rare collaboration between a business school and a cancer center,” Ahire says. “The work contributes directly to advancing the science of cancer treatment by facilitating selection of the right trials.”