The valley of death between lab and product

Companies stop developing many drugs that were safe but did not work in the disease they tried. Sharing those drugs and their data lets others test them where they might work.

Investors will not back a single university drug because most fail. A fund that finances fifty of them at once in exchange for a small slice of each one's future royalties spreads the risk enough to attract capital.

The studies needed before a first human trial cost a few million and no grant pays for them. A dedicated fund would decide in weeks and take a small share of any future revenue.

Thousands of tests that could predict who benefits from a treatment are published and never validated. A fund would pay for the boring but essential confirmation studies in independent patient groups.

Before any academic compound gets money for pre-trial studies, it would have to show activity in a standard panel of patient-derived tumour models run by an independent centre, so weak candidates are stopped early.

Academic first-in-human trials recruit slowly because each hospital repeats ethics and regulatory review. A network of phase 1 units with one shared review would open trials in many countries at once.

Drugs fail for very different reasons: the target was wrong, the drug did not reach it, the side-effects were too bad, or the trial was badly designed. Recording which reason each time would show where the system is broken.

Running an early trial properly requires monitors, data managers, safety reporting and regulatory filings that universities cannot afford from commercial providers. A public not-for-profit would do this work at cost.

Build a drug company that does not need profits, modelled on the ones that developed new tuberculosis and sleeping-sickness drugs, to take on rare, paediatric and undruggable cancers.

Build a shared, not-for-profit clinical unit that runs early combination trials to a standard recipe, so that small companies and academics can test pairs without building their own trial machinery.

Before investing in a full trial, give a few patients a tiny dose of a new compound and use scans and blood tests to see whether it reaches the tumour and hits its target. Fund these small studies as a matter of routine.

Tools that show surgeons where the tumour ends during the operation could cut the number of patients who need a second operation, but none has been properly tested at scale. A network would run those trials and pay on results.

Companies and public funders would jointly pay for standardised experiments that confirm or refute new cancer targets, sharing all results openly, so nobody wastes years on a target that does not hold up.

Universities often refuse to be the legal sponsor of a first-in-human trial because they cannot afford the insurance and liability. A shared public insurance pool would remove that block.

Thousands of promising cancer compounds sit unused in university freezers and company archives. A public catalogue of what exists, what is known and who to ask would let others pick them up.

Promising academic cancer discoveries stall because nobody funds the expensive step from lab to first human trial. Build a shared public facility that does exactly that step, repeatedly.

Companies hold thousands of well-characterised drugs that could help rare cancers, but each request takes a year of legal negotiation. One standing agreement would unblock it.

Between diagnosis and surgery there are usually a few weeks. Giving a new drug in that window and comparing the tumour before and after surgery shows whether it hits its target in real people, quickly and cheaply.

New surgical tools, imaging probes and radiotherapy hardware invented in universities rarely attract investors. A dedicated fund would pay for prototyping, safety testing and first-in-human studies.

Most new cancer imaging agents and radioactive drugs start in university hospitals. A network sharing production, quality files and regulatory paperwork would get them into multi-centre trials years faster.

Many cancer lab results cannot be reproduced, and trials built on them fail. Fund an independent institute that re-runs important experiments before anyone spends millions on humans.

Academic labs find new tumour targets but cannot turn an antibody into an antibody-drug conjugate or a bispecific without licensed linker and payload technology. A shared platform would provide that at no cost for first trials.

You cannot study a cancer without a laboratory model of it, and most rare cancers have none. A funded bank that makes and shares models would unlock research.

When a company stops developing a cancer drug for business reasons, the rights and data would automatically be offered to charities and universities on set terms after two years, so promising compounds do not disappear.

Fast grants for oncology would be a fund that decides within two days on small grants for quick, decisive experiments in cancers or questions that mainstream funders neglect, modelled on the pandemic-era Fast Grants.

Investors avoid genuinely new cancer drugs because most fail in mid-stage trials. A public insurance scheme would repay part of the loss when a first-in-class drug fails honestly, making the bet worth taking.

European law already lets hospitals make advanced therapies for their own patients. Pair that with a shared outcomes registry so academic CAR-Ts and similar treatments can prove themselves without a commercial licence.

Doctors who could turn discoveries into trials are buried in clinical work. Hospitals would guarantee them research time and recover the cost from the trials and grants they bring in.

Before a new cancer drug from a university is given to people, a separate laboratory should have repeated the main experiment showing it works.

Cancer charities would fund companies to hit specific development milestones, as the cystic fibrosis charity did to create Kalydeco, and take a royalty they reinvest in the next drug.

A drug that works in one laboratory's mice often fails elsewhere. Running the key animal study across several independent laboratories first would catch this.

Clinical trials get expert statistical review; the laboratory studies that justify them usually do not. Paying statisticians to review these papers before they influence a trial would catch errors early.

Dogs get cancers that closely resemble human ones, with real immune systems and years of natural history. Treating them, with owner consent, can test drugs in a way mice cannot.

Building a cell-therapy factory costs tens of millions, so most good academic ideas never reach patients. Shared public facilities would give them a route to the clinic.

A public investment fund would match private money in the riskiest early trials of truly new cancer drugs, taking a small share of future royalties so that taxpayers gain when the bets pay off.

Build a handful of publicly-funded centres where academic discoveries can be manufactured to clinical grade and written up for regulators, so good ideas do not die for lack of a factory and a filing.

The US government already runs a small programme that turns academic cancer discoveries into drugs ready for human trials. Scale it up tenfold and copy it in other countries.

Robotic labs guided by AI that design experiments on tumour models, run them, read the results and design the next ones, around the clock, with every result published openly.

Before spending millions to turn a lab finding into a drug, spend a little to have an independent lab check it is real. Funders would reserve a small slice of money for exactly this.

Personalised cancer vaccines and cell therapies need a factory for each patient. Shared, automated production units serving many academic hospitals would let universities run these trials without building their own plants.

Postdocs who discover something promising usually have to leave it behind when their contract ends. A fellowship would pay them for two years to turn it into a candidate drug or diagnostic, with mentors from industry.