{"entity":{"id":"idea-moon-generics-for-cancer-fund","kind":"idea","name":"A public fund and label pathway to trial generic drugs against cancer","aka":[],"tldr":"Cheap old drugs such as aspirin, statins, metformin and beta-blockers show hints of cancer benefit but no company will pay for the trials. Create a public fund and a way to update their labels.","summary":"Repurposing candidates with plausible mechanisms and observational signals rarely reach definitive trials because generic status removes the commercial incentive; the aspirin adjuvant trials (ADD-ASPIRIN) are a rare exception. The proposal is a dedicated public fund for pragmatic, registry-embedded randomised trials of generics in defined cancer indications, coupled with a regulatory pathway allowing third parties (academic groups, health systems) to obtain label updates, and payer commitments to reimburse on positive results.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (No incentive to repurpose cheap drugs): Pantziarka et al., The Repurposing Drugs in Oncology (ReDO) Project (ecancer 2014)","url":"https://doi.org/10.3332/ecancer.2014.442"}],"tags":[],"related":[],"cancers":["colorectal","breast-hr-positive","prostate"],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":["cruk"],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-generic-repurposing","b-incentive-misalignment"],"keyPapers":["paper-pantziarka-ecancermedicalscience"],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"The fund completes at least ten definitive repurposing trials in a decade and delivers at least two new indications with population-level mortality impact at negligible drug cost.","rationale":"The candidate list is long, the drugs are safe and cheap, and pragmatic trial designs make each question affordable; the missing element is an owner with an incentive.","test":"Fund five trials in the first tranche (for example beta-blockers in early breast cancer, statins in high-risk prostate cancer, metformin in specific contexts) with pre-registered designs and registry follow-up.","maturity":"early-clinical","actor":"policy","cost":"large","horizonYears":6},"route":"/ideas/idea-moon-generics-for-cancer-fund/","neighbours":{"cancer":[{"id":"colorectal","kind":"cancer","name":"Colorectal cancer","route":"/cancers/colorectal/"},{"id":"breast-hr-positive","kind":"cancer","name":"HR-positive / HER2-negative breast cancer","route":"/cancers/breast-hr-positive/"},{"id":"prostate","kind":"cancer","name":"Prostate cancer","route":"/cancers/prostate/"}],"institution":[{"id":"cruk","kind":"institution","name":"Cancer Research UK","route":"/institutions/cruk/"}],"bottleneck":[{"id":"b-incentive-misalignment","kind":"bottleneck","name":"Incentives reward me-too drugs and marginal gains","route":"/bottlenecks/b-incentive-misalignment/"},{"id":"b-generic-repurposing","kind":"bottleneck","name":"No incentive to repurpose cheap drugs","route":"/bottlenecks/b-generic-repurposing/"}],"paper":[{"id":"paper-pantziarka-ecancermedicalscience","kind":"paper","name":"The Repurposing Drugs in Oncology (ReDO) Project","route":"/key-papers/paper-pantziarka-ecancermedicalscience/"}],"idea":[{"id":"idea-prostate-bipolar-androgen-therapy-phase-3-on-pfs2","kind":"idea","name":"Take high-dose testosterone to phase 3, with progression-free survival through the second line as the primary endpoint","route":"/ideas/idea-prostate-bipolar-androgen-therapy-phase-3-on-pfs2/"}]}}