{"entity":{"id":"idea-fund-rt-io-platform","kind":"idea","name":"A neutral platform trial for radiotherapy plus immunotherapy combinations","aka":[],"tldr":"Radiotherapy may make immunotherapy work better, but the trials to test this are scattered and often small. One shared platform, run by radiotherapy groups with drugs supplied by several companies, would settle it faster.","summary":"A master protocol operated by academic radiotherapy groups (through a neutral sponsor) in which multiple companies' immunotherapies are tested in combination with standardised radiotherapy schedules, doses and target volumes across defined indications (oligometastatic disease, locally advanced head and neck, lung, bladder), with a shared control arm and pre-specified translational sampling. Existing RT-IO trials use inconsistent radiotherapy, making negative and positive results hard to interpret. Radiotherapy groups have the trial infrastructure but no access to drugs; companies have drugs but do not prioritise radiotherapy combinations, so the pairing is a natural public-private platform.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (Surgery and radiotherapy cure most, get least): Sullivan et al., Global cancer surgery (Lancet Oncology Commission 2015)","url":"https://doi.org/10.1016/S1470-2045(15)00223-5"}],"tags":[],"related":["radiation-plus-io","idea-fund-neutral-platform-sponsor","idea-fund-radiotherapy-trials-infrastructure"],"cancers":[],"sections":[],"technologies":["sbrt","checkpoint-inhibitor","imrt-igrt"],"targets":[],"drugs":["durvalumab","pembrolizumab","nivolumab"],"companies":[],"institutions":[],"pathways":[],"terms":["abscopal-effect","oligometastatic","basket-umbrella-platform"],"trials":[],"people":["kevin-harrington"],"bottlenecks":["b-surgery-radiation-innovation","b-ip-collaboration","b-combination-space"],"keyPapers":["paper-sullivan-lancet-oncol"],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"A neutral RT-IO platform evaluates at least six immunotherapy agents with standardised radiotherapy within four years and produces at least one positive signal warranting phase 3 and at least two clear negatives, at a per-agent cost below a third of stand-alone RT-IO trials.","rationale":"PACIFIC showed the value of sequencing immunotherapy after chemoradiotherapy; many subsequent trials with poorly standardised radiotherapy have been negative or uninterpretable. Platform designs have worked in glioblastoma and breast cancer; combining them with radiotherapy quality assurance is the missing step.","test":"Launch the platform in one indication with three agents and a shared control, and report activation time, standardisation compliance and per-agent cost against recent stand-alone trials.","maturity":"early-clinical","actor":"research","cost":"large","horizonYears":4},"route":"/ideas/idea-fund-rt-io-platform/","neighbours":{"pairing":[{"id":"radiation-plus-io","kind":"pairing","name":"Radiotherapy + immunotherapy","route":"/pairings/radiation-plus-io/"}],"idea":[{"id":"idea-fund-neutral-platform-sponsor","kind":"idea","name":"A permanent neutral non-profit sponsor for multi-company platform trials","route":"/ideas/idea-fund-neutral-platform-sponsor/"},{"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":"checkpoint-inhibitor","kind":"technology","name":"Immune checkpoint inhibitors","route":"/technologies/checkpoint-inhibitor/"},{"id":"imrt-igrt","kind":"technology","name":"IMRT / IGRT (modern external beam)","route":"/technologies/imrt-igrt/"},{"id":"sbrt","kind":"technology","name":"SBRT / SABR (stereotactic radiotherapy)","route":"/technologies/sbrt/"}],"drug":[{"id":"durvalumab","kind":"drug","name":"Durvalumab","route":"/drugs/durvalumab/"},{"id":"nivolumab","kind":"drug","name":"Nivolumab","route":"/drugs/nivolumab/"},{"id":"pembrolizumab","kind":"drug","name":"Pembrolizumab","route":"/drugs/pembrolizumab/"}],"term":[{"id":"abscopal-effect","kind":"term","name":"Abscopal effect","route":"/terms/abscopal-effect/"},{"id":"basket-umbrella-platform","kind":"term","name":"Basket, umbrella, and platform trials","route":"/terms/basket-umbrella-platform/"},{"id":"oligometastatic","kind":"term","name":"Oligometastatic disease","route":"/terms/oligometastatic/"}],"person":[{"id":"kevin-harrington","kind":"person","name":"Kevin Harrington","route":"/people/kevin-harrington/"}],"bottleneck":[{"id":"b-ip-collaboration","kind":"bottleneck","name":"Secrecy and intellectual property block collaboration","route":"/bottlenecks/b-ip-collaboration/"},{"id":"b-surgery-radiation-innovation","kind":"bottleneck","name":"Surgery and radiotherapy cure most, get least","route":"/bottlenecks/b-surgery-radiation-innovation/"},{"id":"b-combination-space","kind":"bottleneck","name":"Too many combinations to test","route":"/bottlenecks/b-combination-space/"}],"paper":[{"id":"paper-sullivan-lancet-oncol","kind":"paper","name":"Global cancer surgery: delivering safe, affordable, and timely cancer surgery","route":"/key-papers/paper-sullivan-lancet-oncol/"}]}}