# A publicly held library of investigational drugs available for academic combination trials

Source: https://onco.cc/ideas/idea-tr2-public-combination-formulary/  
OnCo record `idea-tr2-public-combination-formulary` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

A government or charity holds stocks of experimental cancer drugs under standing agreements, so academic doctors can test combinations without negotiating with each company separately.

## Summary

NCI's CTEP investigational agent programme has run for decades but covers a narrow set of agents and mostly US sites. A broader, international formulary of investigational and newly approved agents held under pre-agreed terms (including pricing for trial use of approved drugs) would let cooperative groups design combination trials from a menu rather than by bilateral pleading.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Cooperative-group combination trials using formulary agents open at least twelve months faster than matched trials requiring bespoke supply negotiation.
- Rationale: Drug supply is the single largest cause of delay in academic combination trials. A standing formulary shifts the negotiation to once per drug rather than once per trial.
- Proposed test: Expand an existing agent programme to a cohort of twenty agents across five companies, open to non-US cooperative groups, and time the next ten trials against historical controls.
- Maturity: early-clinical
- Actor: policy

## Sources

- NCI CTEP: https://ctep.cancer.gov/

## Connected records

- institutions: [National Cancer Institute (NIH)](https://onco.cc/institutions/nci/)
- companies: [Canadian Cancer Trials Group (CCTG)](https://onco.cc/companies/cctg/), [ECOG-ACRIN Cancer Research Group](https://onco.cc/companies/ecog-acrin/), [SWOG Cancer Research Network](https://onco.cc/companies/swog/), [UNICANCER](https://onco.cc/companies/unicancer/)
- bottlenecks: [Secrecy and intellectual property block collaboration](https://onco.cc/bottlenecks/b-ip-collaboration/), [Too many combinations to test](https://onco.cc/bottlenecks/b-combination-space/)
- ideas: [A non-profit phase 1b combination unit that any drug owner can use](https://onco.cc/ideas/idea-tr2-combination-utility/)

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