OnCo
ideasIdea

A standing platform trial for every major cancer, funded as infrastructure

Rather than building a new trial from scratch for every drug, keep one permanent trial open per cancer where new treatments can be slotted in and dropped out, sharing the same patients, control group and infrastructure.

Perpetual multi-arm platform trials with a common control, Bayesian adaptive randomisation and pre-agreed arm entry and graduation rules, as in I-SPY 2 (breast), STAMPEDE (prostate) and GBM AGILE (glioblastoma). The proposal is to fund the fixed infrastructure (governance, sites, data, statistics) for each of the ten commonest cancers as a public or philanthropic good, with sponsors paying a per-arm fee.

Hypothesis
Platform-enrolled arms will reach a go/no-go decision at half the cost and time per arm of stand-alone phase 2 trials in the same indication, and the number of agents tested per year in each cancer will rise.
Rationale
Fixed costs dominate trial economics. Platforms have already shown faster and cheaper arm evaluation and produced approvals. What is missing is stable funding independent of any single sponsor.
What would test it
Fund two new disease platforms for five years and compare cost and time per arm and per approval-supporting result with contemporaneous stand-alone trials in the same indications.
Maturity
being tested at scale
Who has to act
philanthropy
Cost to try
Large (over $50M)
Years to first evidence
5
Bottlenecks it attacks

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