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The Hidden Delays & Costs of Clinical Packaging & Labeling – and How to Avoid Them
Practical insights from industry experts.

Case study

Case Study

Faster Supply Timelines Through Dual-Path Clinical Labeling & Distribution in the EU & US

Trial Sponsor: Carthera, a clinical-stage medtech company, spin-off from AP-HP (Greater Paris University Hospitals), the largest hospital group in Europe, and Sorbonne University.
Study: SONOBIRD_SC9-GMB-03, A randomized, open-label, multicentric, two-arm pivotal trial of SonoCloud-9® combined with carboplatin (CBDCA) vs standard of care lomustine (CCNU) or temozolomide (TMZ) in patients undergoing planned resection for first recurrence glioblastoma
Participants: 560 patients
Duration: Ongoing Trial
Investigational Sites / Countries: More than 50 sites in both the United States and Europe (10 EU countries)

coordinated of packaging operations and distribution

Challenge

In global clinical trials, supply timelines are rarely delayed by a single barrier. Instead, they result from the accumulation of regulatory, logistical, and operational interdependencies.

For Carthera, the study introduced multiple operational constraints: Management of several products, each with distinct temperature and supply requirements, temperature controlled primary and secondary labeling, tight coordination of packaging operations and distribution planning to ensure simultaneous site readiness across the EU and US.

Under these conditions, a fully sequential supply model would have introduced delays incompatible with the study’s accelerated timeline for certain products.

The Myonex Solution

To protect study timelines and maintain full operational control, Myonex implemented a dual-path clinical labeling and distribution strategy, enabling parallel supply execution across both regions.

Rather than relying solely on a sequential workflow, operations were designed to run independently in the US and EU where needed, removing critical dependencies and accelerating overall readiness.

The ultrasound resonator, a component of the Sonocloud-9 system is managed as an Investigational Medicinal Product (IMP). Supplied from the United States and stored at +2/+8°C, it requires two dedicated supply streams. In the US, Myonex performs primary and secondary labeling at its Horsham facility, managing both single-label printing and application before direct distribution to clinical sites nationwide. In parallel, the EU pathway involves booklet labeling at Myonex Le Haillan (France), followed by distribution across 10 European countries.

Carboplatin, the second IMP, is supplied from an EU country and stored at +15/+25°C. Labeling operations for both regions are performed at Myonex Le Haillan (France). From there, distribution flows are split: EU sites are supplied with the booklet-labeled products directly from Le Haillan, while batches intended for the US, with single-label formats, are shipped to Horsham for final on-demand distribution to sites.

This structure ensured simultaneous readiness across regions, while avoiding delays associated with sequential models for certain products. In this case, it eliminates the need for import licenses in some cases, reduces transport complexity and associated costs, and minimizes the risk of temperature excursions by limiting unnecessary product movement.

In addition, Myonex coordinates the Just-in-Time labeling and distribution of the blood brain barrier-opening device, SonoCloud-9®, the implantation kits and connectors, alongside drug supply. With no temperature-control constraints, these components were aligned with drug distribution timelines to ensure full operational readiness at site level.

Execution is driven by close, continuous coordination between Myonex teams in the US and France, with global study oversight by a dedicated Global Project Lead and local project management at each Myonex facility, ensuring alignment, compliance, and full control over timelines.

“The dual path strategy implemented by Myonex was instrumental in keeping our trial on track. Their ability to redesign supply flows, anticipate constraints, and coordinate execution across two continents gave us confidence at every stage. Despite compressed timelines, we achieved simultaneous site readiness in the EU and US.”
– Charlotte Schmitt, Director of Clinical Operations Carthera

Carthera

Results

First Patient In Maintained: Supply readiness ensured in EU and the US, with no delay to First Patient In.

Minimized Import-Related timelines: Import constraints removed for the Definity drug supply in the US, avoiding potential regulatory delays.

On-Time, Compliant Distribution: Shipments are being delivered on time across EU and US, with full compliance and strict cold chain control.

Product Integrity Secured: Optimized flows minimize movement, reducing temperature excursion risks.

Patient care

Conclusion

Faster clinical supply timelines are not achieved by pushing harder within a single process; they are achieved by redesigning execution to eliminate dependencies.

By implementing a dual-path clinical labeling and distribution strategy across the EU and US, Myonex enabled Carthera to safeguard timelines and ensure full study readiness despite compressed conditions.

In clinical trials, speed is not a function of effort. It’s a function of execution design.