Treat resistance like an infectious disease and run national surveillance
Countries track how bacteria become resistant to antibiotics and publish it. Doing the same for cancer drugs would show which escape routes are becoming common and where.
Routine post-progression sequencing already happens in many health systems but the results are not aggregated. A surveillance system, modelled on antimicrobial resistance reporting, would pool de-identified mechanism data by drug, line and region, publish periodic reports, and flag emerging mechanisms early. Laboratories would submit structured results as a condition of accreditation or reimbursement.
- Acquired resistance to every therapy · Nearly every targeted therapy stops working within months to a few years as the tumour adapts.
- Weak real-world evidence and registries · We do not reliably know what happens to patients after approval, so we cannot tell which drugs deliver in practice.
- Data silos · Records, scans, genomes and outcomes sit in separate systems that cannot talk. Every patient's experience is lost to the next.
Pages like this
not linked directly; found by shared links- IdeaFund a biopsy at progression, every time, as standard care
Shares Drug resistance (primary and acquired), Data silos, Acquired resistance to every therapy, Comprehensive genomic profiling.
- IdeaNo mCODE, no payment: tie oncology reimbursement to a minimal structured record
Shares Weak real-world evidence and registries, Real-world evidence, Data silos.
- InstitutionIntermountain Health Cancer Center
Shares Weak real-world evidence and registries, Real-world evidence, Data silos, Comprehensive genomic profiling.
- IdeaOpen, benchmarked algorithms for lines of therapy and progression from routine data
Shares Weak real-world evidence and registries, Real-world evidence, Data silos.
- IdeaAutomatic weekly linkage of cancer registries to deaths, prescriptions and imaging
Shares Weak real-world evidence and registries, Real-world evidence, Data silos.
- IdeaSend the code to the data: a federated analytics network of cancer centres
Shares Weak real-world evidence and registries, Real-world evidence, Data silos.
- IdeaA global federated real-world evidence network at regulatory grade
Shares Weak real-world evidence and registries, Real-world evidence, Data silos.
- IdeaUniversal tumour and germline sequencing at diagnosis feeding a shared learning system
Shares Weak real-world evidence and registries, Real-world evidence, Data silos, Comprehensive genomic profiling.