Ensuring Regulatory Compliance During Clinical Feasibility Assessments

Introduction to Regulatory Oversight in Feasibility Planning

Feasibility assessments are not merely operational tools for site selection—they are regulatory expectations. Both the U.S. Food and Drug Administration (FDA) and the European Medicines Agency (EMA), along with other global authorities, expect sponsors and CROs to conduct structured and documented feasibility assessments as part of Good Clinical Practice (GCP) compliance. Feasibility questionnaires, data validation, and documentation must align with ICH E6(R2), which emphasizes risk-based trial planning and site qualification.

Failure to perform adequate feasibility assessments has been cited in multiple inspection reports. These findings often involve:

• Inadequate documentation of site capability assessments
• Inconsistent feasibility processes across countries or trials
• Overreliance on self-reported, unvalidated data
• Absence of feasibility SOPs or version control

In this tutorial, we cover how to design and execute feasibility assessments that are fully compliant with regulatory requirements. We include real-world examples, inspection citations, and tools to ensure documentation and process rigor.

Regulatory Frameworks Governing Feasibility

The following frameworks guide regulatory expectations around feasibility in clinical development:

• ICH E6(R2) GCP Guidelines: Requires sponsors to evaluate investigator and site suitability (Section 5.6 and 5.18)
• FDA Compliance Program Manual 7348.811: Recommends inspection of sponsor site selection criteria
• EMA GCP Inspectors Working Group Reflection Paper: Highlights deficiencies in feasibility documentation as a key inspection risk
• MHRA GCP Guide: Emphasizes robust feasibility as part of trial start-up planning

These guidelines stress not only the presence of a feasibility assessment but also its documentation, validation, and consistency across clinical programs.

Minimum Documentation Requirements

A regulatory-compliant feasibility package should include:

For example, if a site claims they can enroll 40 patients with a rare genetic disorder, the sponsor must retain justification such as regional disease prevalence reports, or prior enrollment records validated by registry data like Japan’s RCT Portal.

Common Regulatory Audit Findings

Below are real-world FDA and EMA audit observations related to feasibility:

• “The sponsor did not document the criteria used for selecting investigator sites.”
• “Feasibility assessments lacked supporting data to justify projected recruitment timelines.”
• “No evidence that sponsor reviewed investigator GCP training prior to site initiation.”
• “Feasibility SOP was outdated and inconsistently applied across regions.”

These findings not only delay trial progression but can result in critical or major inspection outcomes that require CAPA submission and re-inspection.

Role of Feasibility SOPs and Governance

Sponsors must implement and follow a standardized feasibility SOP that defines:

• Responsibilities of feasibility managers, CRAs, and medical reviewers
• Timing of feasibility (pre-IRB, pre-contract)
• Use of digital platforms and validation of e-questionnaires
• Criteria for scoring and risk ranking of sites
• Filing of completed questionnaires in eTMF

The SOP should also include annexures for therapeutic-specific feasibility checklists (e.g., oncology, CNS, vaccines) and region-specific adaptations (e.g., India, China, EU).

Governance committees should oversee feasibility quality by conducting:

• Spot audits of feasibility responses
• Review of enrollment accuracy versus feasibility predictions
• Corrective Action Plans (CAPA) for overestimated sites

Data Integrity and Electronic Feasibility Tools

When using digital platforms, the feasibility process must maintain data integrity standards in line with 21 CFR Part 11 and Annex 11. This includes:

• Audit trails for each change in survey response
• Unique user access for PIs and staff completing the forms
• Electronic signature certification and locking of final entries
• Data backup and disaster recovery plans for e-feasibility tools

For example, if a feasibility platform allows sites to revise their estimated enrollment, the system must log who made the change, when, and why—ensuring full traceability.

Cross-Verification with Source Systems

Feasibility responses must be cross-verified with:

• Clinical Trial Management Systems (CTMS): Prior performance data
• eTMF: GCP training records, signed PI forms
• Public registries: Recruitment metrics from prior trials

This prevents sites from overstating capacity or infrastructure. Some sponsors use feasibility scoring dashboards that auto-rank sites based on enrollment history, deviation rates, and startup timelines—integrated with CTMS and analytics tools.

Regulatory Expectations by Region

Global feasibility assessments must incorporate branching logic or country-specific forms to meet these requirements.

Checklist for Regulatory-Compliant Feasibility

• Completed and signed questionnaire by PI or designee
• Supporting documents for patient estimates and equipment
• GCP certification and CVs reviewed
• Feasibility scoring or risk ranking documented
• SOP version used is up to date and applied consistently
• All documents filed in audit-ready location (eTMF)

Conclusion

Feasibility assessments are not just an operational exercise—they are a regulatory obligation. Sponsors and CROs must ensure their feasibility process is governed by SOPs, aligned with global regulations, and fully documented. Leveraging digital tools, cross-verifying with historical data, and training teams in compliance best practices is essential. With regulatory inspections becoming more rigorous, proper feasibility assessments reduce trial risk, improve start-up timelines, and enhance overall study quality.