{"entity":{"id":"idea-tr2-combination-utility","kind":"idea","name":"A non-profit phase 1b combination unit that any drug owner can use","aka":[],"tldr":"Build a shared, not-for-profit clinical unit that runs early combination trials to a standard recipe, so that small companies and academics can test pairs without building their own trial machinery.","summary":"Early combination trials repeat the same work: pharmacokinetic interaction, overlapping toxicity, dose finding. A utility unit with standard protocols, pre-negotiated site contracts and a fixed price per arm (analogous to a contract research organisation but mission-driven and data-open) would lower the barrier for combinations that no single company will sponsor, especially those pairing drugs from different owners.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (Too many combinations to test): Palmer & Sorger, Combination cancer therapy can confer benefit via patient-to-patient variability without drug additivity or synergy (Cell 2017)","url":"https://doi.org/10.1016/j.cell.2017.11.009"}],"tags":[],"related":["cruk","royal-marsden","icr-london","idea-tr2-public-combination-formulary"],"cancers":[],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-combination-space","b-translational-valley"],"keyPapers":["paper-palmer-cell"],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"The unit will run combination phase 1b arms at less than half the cost and time of industry-sponsored equivalents and will publish every result, positive or negative, within a year of completion.","rationale":"Shared infrastructure works elsewhere in science (synchrotrons, sequencing centres). The UK Experimental Cancer Medicine Centres show the model at national scale.","test":"Fund a unit for five years with a mandate of twenty combination arms; audit cost, time and publication rate against matched industry trials.","maturity":"speculative","actor":"philanthropy","cost":"large","horizonYears":4},"route":"/ideas/idea-tr2-combination-utility/","neighbours":{"institution":[{"id":"cruk","kind":"institution","name":"Cancer Research UK","route":"/institutions/cruk/"},{"id":"icr-london","kind":"institution","name":"The Institute of Cancer Research","route":"/institutions/icr-london/"},{"id":"royal-marsden","kind":"institution","name":"The Royal Marsden","route":"/institutions/royal-marsden/"}],"idea":[{"id":"idea-tr2-public-combination-formulary","kind":"idea","name":"A publicly held library of investigational drugs available for academic combination trials","route":"/ideas/idea-tr2-public-combination-formulary/"}],"bottleneck":[{"id":"b-translational-valley","kind":"bottleneck","name":"The valley of death between lab and product","route":"/bottlenecks/b-translational-valley/"},{"id":"b-combination-space","kind":"bottleneck","name":"Too many combinations to test","route":"/bottlenecks/b-combination-space/"}],"paper":[{"id":"paper-palmer-cell","kind":"paper","name":"Combination Cancer Therapy Can Confer Benefit via Patient-to-Patient Variability without Drug Additivity or Synergy","route":"/key-papers/paper-palmer-cell/"}]}}