A RECOVERY-style permanent platform trial of cheap drugs added to cancer care
The UK's RECOVERY trial tested many cheap COVID drugs quickly by randomising thousands of ordinary hospital patients. Cancer needs the same machine for old drugs.
RECOVERY enrolled tens of thousands of patients with a two-page consent, minimal data collection and routine-data follow-up, delivering definitive answers on dexamethasone and others within months. Oncology has platform trials (GBM AGILE, STAMPEDE, I-SPY) but none dedicated to repurposed generics across common cancers. The proposal is a perpetual pragmatic platform in one or more national health systems, embedded in routine care, randomising patients with common cancers to standard care with or without a generic candidate (statin, metformin, propranolol, aspirin, vitamin D, low-dose naltrexone, itraconazole and others), with survival from registries as the primary outcome and arms added and dropped on interim analyses.
- No incentive to repurpose cheap drugs · Old, cheap drugs with anti-cancer signals never get the trials they need because no one profits from the result.
- 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.