What's in a clinical trial name? Breaking it down with the Brand Institute, from the acronymic to the aspirational

Clinical trial names span a broad range, from straightforward acronyms to more inspiring titles—see: Eli Lilly’s optimistically dubbed family of Triumph trials—to the downright ostentatious, like Delta Force, the action-packed name for Leo Pharma’s study of a hand cream to treat severe chronic eczema.

Essentially, naming a new trial represents a significant marketing opportunity for drug and device makers well before their products ever hit shelves, especially because study monikers, unlike drug names, aren’t subject to regulatory oversight, according to Scott Piergrossi, president of creative for the healthcare industry naming giant Brand Institute. Even so, he added, companies typically take care to stay within certain ethical bounds when devising those names.

“You have more commercial latitude with regard to some messaging in your trial name vs. your drug name, so there is an opportunity to use a real word, to be imagery-driven, to be aspirational—but in a measured and considerate way,” Piergrossi said in an interview with Fierce Pharma Marketing.

“While clinical trial names aren’t reviewed by regulators, you do want to make sure that you aren’t making any claims or using anything that might be perceived as exaggerated, as overly promotional, just for good ethical measure,” he continued. “But there is a net-net greater marketing opportunity in the meaning behind the name.”

So, how does the perfect clinical trial name come about? It often starts in the earliest stages of drug development, sometimes even before a therapeutic candidate has a generic name, and is the brainchild of a typically cross-functional team that might span a company’s commercial, regulatory and trademark divisions.

That team’s ultimate goal “is to come up with a memorable name that might suggest a variety of concepts,” according to Piergrossi. “That might include the trial endpoints; that might include the indication; maybe we’re trying to suggest the broader therapeutic area”—or maybe, he continued, it’s “just an arbitrary and/or aspirational name that the team feels is emotive or appropriate in some way.”

Conveying those concepts can take several forms. One of the most popular, of course, is via acronym, which the naming expert summed up as: “theoretically beautiful; technically and tactically very challenging.”

For an acronymic name to actually be memorable and impactful, it should string together its designated set of words “in a believable and simple way,” he said, meaning that “contrived acronyms,” which might pull letters from all over a series of words, rather than just their starting letters, should be avoided. As examples of strong acronyms, Piergrossi offered up two examples that the Brand Institute helped name: BioLineRx’s Eagle trial, which stands for “Effective Anti-psychosis via GABA-Level Enhancement”—while also offering up images of “freedom, soaring, liberation”—and Nektar Therapeutics’ Beacon trial, denoting “BrEAst Cancer Outcomes with NKTR-102.”

If a similarly clean, straightforward acronym isn’t forthcoming for a particular trial, “don’t force it,” Piergrossi advised. Indeed, he estimated that acronyms only make up about one-third of the trial names the Brand Institute helps create.

The other two-thirds of the company’s trial name output goes in “a variety of directions,” whether that’s signifying an indication, mechanism of action, therapy area or drug name, associating the trial with aspirational imagery or a combination of both. And, in fact, some of those may ultimately end up as “quasi-acronyms” that embed shorter initialisms into longer words.

An example of an indication-focused title that the Brand Institute assisted with is Armata Pharmaceuticals’ trial of its treatment for Staphylococcus aureus, which is stylized as “diSArm” to highlight the bacterium’s nickname while also suggesting the treatment’s ability to immobilize it. Sanofi’s Cdiffense trial works similarly by including both its target—Clostridioides difficile, also known as C. diff—and protective imagery.

On the mechanism-associated front, Piergrossi spotlighted Bristol Myers Squibb’s CXCessoR4 trial, pronounced “successor four,” which encoded the CXCR4 inhibitor being studied within a name that simultaneously suggests “a next-generation product, next-generation mechanism of action.”

As for trial titles integrating drug names, the Brand Institute recently helped devise the name of AstraZeneca’s BalanceD trial. Piergrossi pointed out that it’s “bookended” by letters standing for the nonproprietary names of the two drugs being studied in combination to treat heart failure patients, balcinrenone and dapagliflozin, while also implying the trial’s goal of “homeostasis” for patients.

He also highlighted several less-stylized names. Unity Biotechnology’s Envision trial of a diabetic macular edema treatment, for example, both nods to the sight-related nature of the trial and contains “aspirational messaging.” Meanwhile, Astellas Pharma’s family of butterfly-related trial names—Chrysalis, Lacewing, Admiral, Commodore and Gossamer—“didn’t have anything to do with” their target of acute myeloid leukemia (AML) or the treatment being studied, then known by its nonproprietary name of gilteritinib, but summoned “approachable imagery” suggesting a potential butterflylike metamorphosis for AML patients.

Whether acronymic or not, all of Piergrossi’s examples offer hopeful, positive imagery in one way or another—a practice that has earned the ire of some critics, who claim that the optimism imbued in some trial names may be misleading to patients and doctors considering participating.

One 2021 article published in the journal Accountability in Research concluded that a majority of acronymic trial names contain “appealing linguistic cues” based on the same marketing psychology behind perfume names. The authors called such names “manipulative,” writing: “Through overt or subliminal enticement, inspirational acronyms that downplay the risks or raise expectations to patients with life-threatening illnesses, may exert undue influence.”

Piergrossi disagreed with those claims, saying the Brand Institute’s clients are typically able to find a balance between coming up with trial names that are “very image-driven and hopeful and aspirational” and staying “acutely aware of the regulatory environment” to avoid any that may be perceived as overly promotional.

At the end of the day, he said, “all of these trials need to recruit patients … and we’ve seen that branded clinical trials do result in higher awareness, they do net-net improve enrollments vs. unbranded trials, and there is a possibility for improved communication from healthcare providers and patients and researchers when referencing or citing the study.”

Piergrossi went on to point out that consumers’ lasting affinities for major brands like Apple or their decisions to try out new brands stem from a variety of factors, including the design, type and overall quality of a company’s products, with only a “relatively loose connection” to the brand name alone—a practice that he suggested carries over to clinical trial enrollment.

“I don’t give a ton of credence to the idea that the name has this overriding influence on whether, in this instance, I’m going to enroll in a clinical trial,” he said.

“The patient’s emotional connection and associations with the trial are much more associated with their underlying disease state and their hope to get healthier,” he continued. “They’d want to enroll in that trial because they have the underlying disease, and they want to help the scientific community understand if this molecule works and, by extension, if it might help them as well.”