OnCo
ideasIdea

A shared library of pooled control arms to shrink and speed future trials

Thousands of patients have received standard treatment in the control arms of past trials. Pooling their anonymised data would let new trials borrow from them and randomise fewer patients to old treatments.

A curated commons of individual patient data from control arms of completed oncology trials, standardised by indication, line of therapy and era, with covariates sufficient for matching and Bayesian borrowing, governed by the data trust and accepted by regulators as a source for external or hybrid control arms under pre-specified conditions. Sponsors contributing control data receive access rights. Regulators (FDA's real-world evidence and complex innovative design programmes, EMA's qualification opinions) have signalled openness to external controls where data quality is high; the commons provides the quality and the scale.

Hypothesis
Trials using commons-derived hybrid controls under pre-agreed methodology reach the same conclusions as fully randomised trials in retrospective emulation for at least 90% of tested cases, and their prospective use reduces control-arm enrolment by a third in rare and late-line indications.
Rationale
Project Data Sphere's pooled control arms have already supported prognostic models and trial design; regulatory acceptance of external controls has grown for rare diseases. Oncology has the volume of standardised trial data to make borrowing statistically credible.
What would test it
Assemble commons data for three indications, run pre-registered emulations of recent randomised trials, and pilot a prospective hybrid-control trial with regulatory agreement.
Maturity
early clinical
Who has to act
data
Cost to try
Medium ($1M to $50M)
Years to first evidence
3
Bottlenecks it attacks

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