{"entity":{"id":"idea-tr2-public-combination-formulary","kind":"idea","name":"A publicly held library of investigational drugs available for academic combination trials","aka":[],"tldr":"A government or charity holds stocks of experimental cancer drugs under standing agreements, so academic doctors can test combinations without negotiating with each company separately.","summary":"NCI's CTEP investigational agent programme has run for decades but covers a narrow set of agents and mostly US sites. A broader, international formulary of investigational and newly approved agents held under pre-agreed terms (including pricing for trial use of approved drugs) would let cooperative groups design combination trials from a menu rather than by bilateral pleading.","asOf":"2026-09-08","links":[{"label":"NCI CTEP","url":"https://ctep.cancer.gov/"}],"tags":[],"related":["nci","ecog-acrin","swog","unicancer","cctg"],"cancers":[],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-combination-space","b-ip-collaboration"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"Cooperative-group combination trials using formulary agents open at least twelve months faster than matched trials requiring bespoke supply negotiation.","rationale":"Drug supply is the single largest cause of delay in academic combination trials. A standing formulary shifts the negotiation to once per drug rather than once per trial.","test":"Expand an existing agent programme to a cohort of twenty agents across five companies, open to non-US cooperative groups, and time the next ten trials against historical controls.","maturity":"early-clinical","actor":"policy","cost":"medium","horizonYears":3},"route":"/ideas/idea-tr2-public-combination-formulary/","neighbours":{"institution":[{"id":"nci","kind":"institution","name":"National Cancer Institute (NIH)","route":"/institutions/nci/"}],"company":[{"id":"cctg","kind":"company","name":"Canadian Cancer Trials Group (CCTG)","route":"/companies/cctg/"},{"id":"ecog-acrin","kind":"company","name":"ECOG-ACRIN Cancer Research Group","route":"/companies/ecog-acrin/"},{"id":"swog","kind":"company","name":"SWOG Cancer Research Network","route":"/companies/swog/"},{"id":"unicancer","kind":"company","name":"UNICANCER","route":"/companies/unicancer/"}],"bottleneck":[{"id":"b-ip-collaboration","kind":"bottleneck","name":"Secrecy and intellectual property block collaboration","route":"/bottlenecks/b-ip-collaboration/"},{"id":"b-combination-space","kind":"bottleneck","name":"Too many combinations to test","route":"/bottlenecks/b-combination-space/"}],"idea":[{"id":"idea-tr2-combination-utility","kind":"idea","name":"A non-profit phase 1b combination unit that any drug owner can use","route":"/ideas/idea-tr2-combination-utility/"}]}}