# Trial-in-a-box: a preconfigured protocol kit any hospital can open for a rare cancer

Source: https://onco.cc/ideas/idea-tr1-rare-cancer-trial-in-a-box/  
OnCo record `idea-tr1-rare-cancer-trial-in-a-box` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

For rare cancers, the patient is often at a hospital that has no trial. A ready-made kit with the protocol, consent forms, database and shipping already set up would let that hospital enrol them within days.

## Summary

A cooperative group or rare-cancer consortium maintains modular, pre-approved protocol packages for rare histologies: template protocol with pre-negotiated ethics approval under a central IRB, eConsent, cloud EDC, sample-shipping kits and a remote investigator-of-record model where local clinicians act as sub-investigators. Combined with just-in-time activation, the kit lets any accredited hospital enrol its one patient.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Rare-cancer trials using a trial-in-a-box model will enrol from at least three times as many sites and reach accrual targets faster than conventional multicentre rare-cancer trials.
- Rationale: Rare-cancer trials fail on accrual because patients are scattered; every patient not enrolled is a large fraction of the target. Paediatric oncology achieves high enrolment through standardised cooperative-group infrastructure that adult rare-cancer trials lack.
- Proposed test: Deploy a kit for one rare adult sarcoma or neuroendocrine subtype across a national network and compare enrolment per eligible incident case with a historical trial in the same subtype.
- Maturity: speculative
- Actor: research

## Sources

- Bottleneck evidence (Trials enrol too few, too slowly): Unger et al., Systematic review of barriers to cancer trial participation (JNCI 2019): https://doi.org/10.1093/jnci/djy221

## Connected records

- cancers: [Biliary tract cancer (cholangiocarcinoma)](https://onco.cc/cancers/cholangiocarcinoma/), [Mesothelioma](https://onco.cc/cancers/mesothelioma/), [Neuroendocrine tumours](https://onco.cc/cancers/neuroendocrine/), [Sarcomas (soft tissue, bone, GIST)](https://onco.cc/cancers/sarcoma/)
- companies: [EORTC](https://onco.cc/companies/curie-nki-eortc/)
- terms: [Basket, umbrella, and platform trials](https://onco.cc/terms/basket-umbrella-platform/)
- bottlenecks: [Rare and paediatric cancers without markets](https://onco.cc/bottlenecks/b-rare-cancers/), [Trials enrol too few, too slowly](https://onco.cc/bottlenecks/b-trial-enrolment/)

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