{"entity":{"id":"idea-fund-public-nonprofit-cro","kind":"idea","name":"A national non-profit contract research organisation for academic oncology trials","aka":[],"tldr":"Running an early trial properly requires monitors, data managers, safety reporting and regulatory filings that universities cannot afford from commercial providers. A public not-for-profit would do this work at cost.","summary":"A publicly-owned or non-profit CRO providing sponsor-level services (protocol development, regulatory submissions, monitoring, pharmacovigilance, data management, statistics) to academic phase 1 and 2 oncology trials at cost, funded partly by a core grant and partly by fees charged to grants. Academic trials fail or stall for operational, not scientific, reasons; commercial CRO fees consume a large share of academic trial budgets. Precedents include the UK's NIHR clinical research network infrastructure, the EORTC headquarters model for European academic trials, and NCI's CTEP for investigational agents.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (The valley of death between lab and product): Butler, Translational research: crossing the valley of death (Nature 2008)","url":"https://doi.org/10.1038/453840a"}],"tags":[],"related":["idea-fund-translational-institutes-gmp","idea-fund-global-academic-phase-one-network"],"cancers":[],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":["curie-nki-eortc"],"institutions":["nci"],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-translational-valley","b-trial-design"],"keyPapers":["paper-reproducibility-project-cancer-biology-elife-2021","paper-butler-nature"],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"Academic trials supported by a non-profit CRO complete recruitment and report results at least 30% faster than academic trials using commercial or in-house ad hoc support, at lower total cost per patient.","rationale":"EORTC and the German and UK cooperative trials units show that shared professional infrastructure lifts completion rates and quality; a non-profit CRO extends this from cooperative-group phase 3 to the early-phase academic trials where the valley of death is deepest.","test":"Fund a pilot CRO to sponsor twenty academic phase 1/2 oncology trials and compare start-up time, recruitment velocity, protocol deviations and reporting time against a matched set of contemporaneous academic trials.","maturity":"speculative","actor":"policy","cost":"large","horizonYears":4},"route":"/ideas/idea-fund-public-nonprofit-cro/","neighbours":{"idea":[{"id":"idea-fund-global-academic-phase-one-network","kind":"idea","name":"A global first-in-human network for academic cancer trials with single ethics review","route":"/ideas/idea-fund-global-academic-phase-one-network/"},{"id":"idea-fund-academic-sponsor-indemnity-pool","kind":"idea","name":"A public indemnity pool so universities can sponsor first-in-human cancer trials","route":"/ideas/idea-fund-academic-sponsor-indemnity-pool/"},{"id":"idea-fund-translational-institutes-gmp","kind":"idea","name":"Regional translational institutes with academic GMP suites and IND teams","route":"/ideas/idea-fund-translational-institutes-gmp/"}],"company":[{"id":"curie-nki-eortc","kind":"company","name":"EORTC","route":"/companies/curie-nki-eortc/"}],"institution":[{"id":"nci","kind":"institution","name":"National Cancer Institute (NIH)","route":"/institutions/nci/"}],"bottleneck":[{"id":"b-translational-valley","kind":"bottleneck","name":"The valley of death between lab and product","route":"/bottlenecks/b-translational-valley/"},{"id":"b-trial-design","kind":"bottleneck","name":"Trial design, endpoints and cost","route":"/bottlenecks/b-trial-design/"}],"paper":[{"id":"paper-reproducibility-project-cancer-biology-elife-2021","kind":"paper","name":"Reproducibility Project: Cancer Biology found that landmark preclinical results mostly shrank or vanished on replication","route":"/key-papers/paper-reproducibility-project-cancer-biology-elife-2021/"},{"id":"paper-butler-nature","kind":"paper","name":"Translational research: crossing the valley of death","route":"/key-papers/paper-butler-nature/"}]}}