{"entity":{"id":"idea-tr1-standing-platform-per-cancer","kind":"idea","name":"A standing platform trial for every major cancer, funded as infrastructure","aka":[],"tldr":"Rather than building a new trial from scratch for every drug, keep one permanent trial open per cancer where new treatments can be slotted in and dropped out, sharing the same patients, control group and infrastructure.","summary":"Perpetual multi-arm platform trials with a common control, Bayesian adaptive randomisation and pre-agreed arm entry and graduation rules, as in I-SPY 2 (breast), STAMPEDE (prostate) and GBM AGILE (glioblastoma). The proposal is to fund the fixed infrastructure (governance, sites, data, statistics) for each of the ten commonest cancers as a public or philanthropic good, with sponsors paying a per-arm fee.","asOf":"2026-09-08","links":[{"label":"I-SPY Trials","url":"https://www.ispytrials.org/"},{"label":"STAMPEDE trial","url":"https://www.stampedetrial.org/"},{"label":"Global Coalition for Adaptive Research (GBM AGILE)","url":"https://www.gcaresearch.org/"}],"tags":[],"related":["prostate-roadmap","idea-prostate-randomise-the-sequence-not-only-the-drugs"],"cancers":["glioblastoma","prostate","pancreatic"],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["basket-umbrella-platform"],"trials":[],"people":[],"bottlenecks":["b-trial-design","b-trial-enrolment","b-combination-space"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"Platform-enrolled arms will reach a go/no-go decision at half the cost and time per arm of stand-alone phase 2 trials in the same indication, and the number of agents tested per year in each cancer will rise.","rationale":"Fixed costs dominate trial economics. Platforms have already shown faster and cheaper arm evaluation and produced approvals. What is missing is stable funding independent of any single sponsor.","test":"Fund two new disease platforms for five years and compare cost and time per arm and per approval-supporting result with contemporaneous stand-alone trials in the same indications.","maturity":"being-tested-at-scale","actor":"philanthropy","cost":"large","horizonYears":5},"route":"/ideas/idea-tr1-standing-platform-per-cancer/","neighbours":{"roadmap":[{"id":"prostate-roadmap","kind":"roadmap","name":"Prostate cancer roadmap: from Huggins and the discovery that a cancer can depend on a hormone, through the PSA epidemic and what it cost, the androgen receptor drugs, the DNA repair subset and PSMA, to a 2032 registry watch","route":"/roadmaps/prostate-roadmap/"},{"id":"trial-modernisation-roadmap","kind":"roadmap","name":"Trial modernisation roadmap: the randomised trial → platforms and adaptive designs → decentralised, pragmatic and always-on","route":"/roadmaps/trial-modernisation-roadmap/"}],"idea":[{"id":"idea-prostate-randomise-the-sequence-not-only-the-drugs","kind":"idea","name":"Randomise the order of treatment, not only the drugs: a strategy platform for metastatic prostate cancer","route":"/ideas/idea-prostate-randomise-the-sequence-not-only-the-drugs/"}],"cancer":[{"id":"glioblastoma","kind":"cancer","name":"Glioma & glioblastoma","route":"/cancers/glioblastoma/"},{"id":"pancreatic","kind":"cancer","name":"Pancreatic ductal adenocarcinoma","route":"/cancers/pancreatic/"},{"id":"prostate","kind":"cancer","name":"Prostate cancer","route":"/cancers/prostate/"}],"term":[{"id":"basket-umbrella-platform","kind":"term","name":"Basket, umbrella, and platform trials","route":"/terms/basket-umbrella-platform/"}],"bottleneck":[{"id":"b-combination-space","kind":"bottleneck","name":"Too many combinations to test","route":"/bottlenecks/b-combination-space/"},{"id":"b-trial-design","kind":"bottleneck","name":"Trial design, endpoints and cost","route":"/bottlenecks/b-trial-design/"},{"id":"b-trial-enrolment","kind":"bottleneck","name":"Trials enrol too few, too slowly","route":"/bottlenecks/b-trial-enrolment/"}]}}