{"entity":{"id":"idea-tr2-failure-taxonomy","kind":"idea","name":"A machine-readable taxonomy of why cancer drugs fail","aka":[],"tldr":"Drugs fail for distinct reasons: wrong target, drug never reached it, unacceptable toxicity, unselected population or poor trial design. A shared machine-readable taxonomy applied to every discontinued oncology programme in public pipeline databases would show where the system breaks, as AstraZeneca and Pfizer's own attrition analyses did.","summary":"Analyses of attrition (for example those published by AstraZeneca and Pfizer on their own pipelines) show that failure reasons are learnable but rarely recorded consistently. A shared taxonomy (target biology, exposure, safety, efficacy in unselected population, biomarker failure, design, commercial) applied to every discontinued oncology programme in public pipeline databases would enable system-level diagnosis and comparison across sponsors and decades.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (Failures are hidden): Anderson et al., Compliance with results reporting at ClinicalTrials.gov (NEJM 2015)","url":"https://doi.org/10.1056/NEJMsa1409364"}],"tags":[],"related":["idea-tr2-termination-reports","idea-tr2-target-failure-index"],"cancers":[],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-negative-results","b-translational-valley"],"keyPapers":["paper-anderson-n-engl-j-med"],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"Applying the taxonomy to a decade of discontinuations will show that at least a third of efficacy failures were preceded by inadequate target-validation or exposure evidence, quantifying an avoidable loss.","rationale":"Aviation and surgery improved by classifying failure. Pharma's 'five Rs' framework (right target, tissue, safety, patient, commercial) is a start that has not been applied openly.","test":"Curate 500 discontinued oncology programmes with two independent coders; publish inter-rater reliability and the distribution of causes.","maturity":"speculative","actor":"data","cost":"small","horizonYears":2},"route":"/ideas/idea-tr2-failure-taxonomy/","neighbours":{"idea":[{"id":"idea-tr2-reversal-registry","kind":"idea","name":"A public registry of cancer treatments that were later shown not to work","route":"/ideas/idea-tr2-reversal-registry/"},{"id":"idea-tr2-target-failure-index","kind":"idea","name":"A target de-risking index that counts failures as well as successes","route":"/ideas/idea-tr2-target-failure-index/"},{"id":"idea-tr2-termination-reports","kind":"idea","name":"Public post-mortem reports when a cancer drug programme is stopped","route":"/ideas/idea-tr2-termination-reports/"},{"id":"idea-tr2-model-report-cards","kind":"idea","name":"Score every preclinical model by how often it predicted the clinical result","route":"/ideas/idea-tr2-model-report-cards/"}],"bottleneck":[{"id":"b-negative-results","kind":"bottleneck","name":"Failures are hidden","route":"/bottlenecks/b-negative-results/"},{"id":"b-translational-valley","kind":"bottleneck","name":"The valley of death between lab and product","route":"/bottlenecks/b-translational-valley/"}],"paper":[{"id":"paper-anderson-n-engl-j-med","kind":"paper","name":"Compliance with results reporting at ClinicalTrials.gov","route":"/key-papers/paper-anderson-n-engl-j-med/"}]}}