One master trial for cancer prevention drugs across many precancers
Prevention trials are slow and run separately. A shared platform trial across precancers like Barrett's, oral leukoplakia, lung nodules and pancreatic cysts would test many drugs faster.
Each precursor cohort has small stand-alone chemoprevention trials. Propose a master protocol with shared infrastructure, biomarker-defined precursor cohorts, intermediate endpoints (regression, progression-free interval), and adaptive arm addition and dropping, funded jointly by NCI's prevention network and philanthropy.
- Prevention we already have is not deployed · Around four in ten cancers are preventable with tools we already own: vaccines, tobacco control, weight, alcohol, sun and infection control.
- Trial design, endpoints and cost · A phase 3 trial takes years and hundreds of millions of dollars, and often answers a question that has already moved on.
For women at raised risk, a 5-year course of tamoxifen offers long-lasting protection against the commonest kind of breast cancer. Uptake is low because of side effects and fear of rare serious harms; low-dose tamoxifen (TAM-01) is now being tested to improve the balance. It has not been shown to save lives.
A Mediterranean dietary pattern rich in olive oil may lower breast cancer risk, and it is safe and good for the heart anyway. The evidence is suggestive, not definitive, because of the small number of cancers; it should not be presented as proven cancer prevention.
Pages like this
not linked directly; found by shared links- IdeaLow-dose tamoxifen for high-risk women, prescribed by pharmacists and nurses
Shares IBIS-I: five years of tamoxifen keeps preventing breast cancer for at least 20 years, Chemoprevention & risk-reducing surgery, Prevention we already have is not deployed.
- IdeaRegulators accept shrinking of precancer as the endpoint for prevention drug approval
Shares Chemoprevention & risk-reducing surgery, Prevention we already have is not deployed, Trial design, endpoints and cost.
- IdeaA permanent platform trial for supportive-care interventions inside cooperative groups
Shares Basket, umbrella, and platform trials, Trial design, endpoints and cost.
- IdeaGLP-1 drugs to reverse endometrial precancer in women with obesity
Shares Chemoprevention & risk-reducing surgery, Prevention we already have is not deployed.
- IdeaStandards for external control arms built from federated real-world data
Shares Basket, umbrella, and platform trials, Trial design, endpoints and cost.
- IdeaA RECOVERY-style permanent platform trial of cheap drugs added to cancer care
Shares Basket, umbrella, and platform trials, Trial design, endpoints and cost.
- IdeaPublish per-patient trial cost benchmarks and target halving them
Shares National Cancer Institute (NIH), Trial design, endpoints and cost.
- IdeaA perpetual platform trial in every major cancer, funded as infrastructure
Shares Basket, umbrella, and platform trials, National Cancer Institute (NIH), Trial design, endpoints and cost.