OnCo
ideasIdea

A perpetual platform trial in every major cancer, funded as infrastructure

Instead of starting a new trial for every drug pair, keep one always-open trial per cancer that new arms can join and leave, sharing the same control group.

STAMPEDE (prostate) and I-SPY 2 (breast) showed that a standing master protocol with a shared control arm can test many treatments for a fraction of the cost and time of separate trials. Yet most common cancers still have no perpetual platform. The proposal is a ten-year, ring-fenced infrastructure grant per tumour type (lung, colorectal, pancreas, ovary, bladder, glioma, myeloma and others) so that the platform outlives any single sponsor or investigator.

Hypothesis
Cancers with a funded perpetual platform will evaluate at least three times as many combination arms per year, at less than half the per-arm cost, compared with matched cancers relying on stand-alone trials, within five years of funding.
Rationale
STAMPEDE randomised over 10,000 men across ten arms with a single control population and changed standard of care three times. Shared controls, standing ethics approval and pre-built data pipelines remove the fixed costs that make combination trials slow.
What would test it
Fund platforms in two cancers without one (for example pancreas and glioma) and compare arms opened, accrual rate and cost per randomised patient against the two prior years of conventional trials in the same disease.
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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