{"entity":{"id":"idea-fund-non-drug-trial-quota","kind":"idea","name":"A statutory minimum share of public trial money for surgery and radiotherapy","aka":[],"tldr":"Surgery and radiotherapy cure more people than drugs but get a fraction of trial funding because there is no company sponsor. A rule would guarantee them a fixed share of public trial money.","summary":"Public trial funders (NCI's NCTN, NIHR, EU programmes) would set a floor, for example 25%, for trials whose primary intervention is surgical, radiotherapeutic, interventional or a care-pathway change. The floor is justified because private sponsors fund almost all drug phase 3s but essentially no non-drug ones, so public money should preferentially cover the market failure. The quota would be paired with core funding for surgical and radiotherapy trials units and quality assurance.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (Funding follows fashion, not burden): Carter & Nguyen, A comparison of cancer burden and research spending (BMC Cancer 2012)","url":"https://doi.org/10.1186/1471-2407-12-526"}],"tags":[],"related":["idea-fund-surgical-trials-network","idea-fund-radiotherapy-trials-infrastructure"],"cancers":[],"sections":[],"technologies":["sbrt","robotic-surgery","imrt-igrt"],"targets":[],"drugs":[],"companies":["nrg-oncology","alliance-oncology"],"institutions":["the-christie","royal-marsden"],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-funding-allocation","b-surgery-radiation-innovation"],"keyPapers":["paper-sun-bmc-cancer"],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"A 25% floor doubles the number of adequately powered randomised surgical and radiotherapy trials started per year within five years, without reducing the total number of practice-changing results per public dollar.","rationale":"Published audits show surgery and radiotherapy receive a small single-digit share of cancer research funding despite delivering around half of cures; where dedicated infrastructure exists (UK CTRad, TROG, the German Hodgkin Study Group) these fields have produced practice-changing trials at low cost.","test":"Audit one funder's portfolio by intervention type, apply the floor for one funding cycle, and count trials started, completed and practice-changing five years later against the prior cycle.","maturity":"speculative","actor":"policy","cost":"large","horizonYears":5},"route":"/ideas/idea-fund-non-drug-trial-quota/","neighbours":{"idea":[{"id":"idea-fund-surgical-trials-network","kind":"idea","name":"A permanently funded international network for randomised cancer surgery trials","route":"/ideas/idea-fund-surgical-trials-network/"},{"id":"idea-fund-radiotherapy-trials-infrastructure","kind":"idea","name":"Core-funded radiotherapy trials infrastructure with central quality assurance","route":"/ideas/idea-fund-radiotherapy-trials-infrastructure/"}],"technology":[{"id":"imrt-igrt","kind":"technology","name":"IMRT / IGRT (modern external beam)","route":"/technologies/imrt-igrt/"},{"id":"robotic-surgery","kind":"technology","name":"Robotic & minimally invasive surgery","route":"/technologies/robotic-surgery/"},{"id":"sbrt","kind":"technology","name":"SBRT / SABR (stereotactic radiotherapy)","route":"/technologies/sbrt/"}],"company":[{"id":"alliance-oncology","kind":"company","name":"Alliance for Clinical Trials in Oncology","route":"/companies/alliance-oncology/"},{"id":"nrg-oncology","kind":"company","name":"NRG Oncology","route":"/companies/nrg-oncology/"}],"institution":[{"id":"the-christie","kind":"institution","name":"The Christie NHS Foundation Trust","route":"/institutions/the-christie/"},{"id":"royal-marsden","kind":"institution","name":"The Royal Marsden","route":"/institutions/royal-marsden/"}],"bottleneck":[{"id":"b-funding-allocation","kind":"bottleneck","name":"Funding follows fashion, not burden","route":"/bottlenecks/b-funding-allocation/"},{"id":"b-surgery-radiation-innovation","kind":"bottleneck","name":"Surgery and radiotherapy cure most, get least","route":"/bottlenecks/b-surgery-radiation-innovation/"}],"paper":[{"id":"paper-sun-bmc-cancer","kind":"paper","name":"Benefits of hyperthermic intraperitoneal chemotherapy for patients with serosal invasion in gastric cancer: a meta-analysis of the randomized controlled trials","route":"/key-papers/paper-sun-bmc-cancer/"}]}}