Idea votes

Adopted

Ideas that someone outside OnCo has picked up, each with the source that shows it: a trial registration, a programme page, a funding announcement, a publication or a policy document. Every adoption is recorded by hand with its source; nothing is inferred.

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The forty most connected ideas with no thread yet. Start one to open the vote; the first thumbs-up is yours.

• Randomise the order of treatment, not only the drugs: a strategy platform for metastatic prostate cancerEarly clinical · 45 connectionsDiscussstart a thread
• Test every man for DNA repair faults on the day his prostate cancer is found to have spread, not three treatments laterEarly clinical · 45 connectionsDiscussstart a thread
• Watch for the cancer changing cell type before the biopsy says neuroendocrine, and act on itPreclinical evidence · 43 connectionsDiscussstart a thread
• Fixed-duration, chemotherapy-free first-line treatment for the indolent lymphomasBeing tested at scale · 40 connectionsDiscussstart a thread
• Judge a prostate screening programme on metastatic presentation, not on incidence or mortalitySpeculative · 38 connectionsDiscussstart a thread
• Publish a per-lesion miss rate for every prostate MRI service before it is allowed to guide focal treatmentEarly clinical · 37 connectionsDiscussstart a thread
• Randomised evidence for the T-cell lymphomas, including the ones that are not in Europe or North AmericaSpeculative · 37 connectionsDiscussstart a thread
• RAS inhibitor combinations and sequence: pan-RAS plus G12D-selective, plus chemotherapy, and what to give after progressionBeing tested at scale · 37 connectionsDiscussstart a thread
• Report death from other causes as an outcome of the prostate cancer service, split by deprivation and ethnicityEarly clinical · 36 connectionsDiscussstart a thread
• A randomised trial of antibody-drug conjugate sequence in metastatic triple-negative breast cancerEarly clinical · 35 connectionsDiscussstart a thread
• Randomise organ preservation against surgery in mismatch repair-proficient rectal cancer, with bowel function as a co-primary endpointBeing tested at scale · 35 connectionsDiscussstart a thread
• A radiotherapy-free cure for early Hodgkin lymphoma that actually holdsBeing tested at scale · 34 connectionsDiscussstart a thread
• Take ctDNA-guided de-escalation beyond stage II, and stop escalating on a positive result until a trial says it helpsBeing tested at scale · 34 connectionsDiscussstart a thread
• Select microsatellite stable patients for immunotherapy by a measured immune biomarker, not by how many treatments they have already failedEarly clinical · 33 connectionsDiscussstart a thread
• ctDNA-guided adjuvant decisions after residual disease: escalate the positive, spare the negativeEarly clinical · 32 connectionsDiscussstart a thread
• Measure the late effects of the treatments being given now, not the ones given in 1975Speculative · 32 connectionsDiscussstart a thread
• Report the time from apheresis to infusion as a trial endpoint, not a logistics footnoteEarly clinical · 32 connectionsDiscussstart a thread
• Take high-dose testosterone to phase 3, with progression-free survival through the second line as the primary endpointEarly clinical · 32 connectionsDiscussstart a thread
• Use circulating tumour DNA instead of the interim scan to decide what happens nextEarly clinical · 30 connectionsDiscussstart a thread
• Hospital-based CAR-T manufacturing at cost through a public networkEarly clinical · 28 connectionsDiscussstart a thread
• Assign first-line treatment in diffuse large B-cell lymphoma by genetic subtype, not by a three-antibody stainPreclinical evidence · 27 connectionsDiscussstart a thread
• Chemotherapy before surgery for every resectable pancreatic cancer, settled by the two perioperative trials rather than assumedBeing tested at scale · 27 connectionsDiscussstart a thread
• Measure brain metastasis prevention as a primary endpoint, not as a secondary oneEarly clinical · 27 connectionsDiscussstart a thread
• Run small-cell lung cancer as one platform with shared controls and subtype stratificationPreclinical evidence · 27 connectionsDiscussstart a thread
• The drugs that cure lymphoma, and the places that do not have themSpeculative · 27 connectionsDiscussstart a thread
• Give exceptional responders less: pembrolizumab omission after complete response, anthracycline-free regimens and chemotherapy omission in lymphocyte-rich stage I diseaseBeing tested at scale · 26 connectionsDiscussstart a thread
• Making microsatellite-stable colorectal cancer immunotherapy-responsiveEarly clinical · 26 connectionsDiscussstart a thread
• Pooled coverage-with-evidence for proton therapy across all centresBeing tested at scale · 26 connectionsDiscussstart a thread
• Treat screening uptake, not test sensitivity, as the thing to optimise, and settle the age extension with a trial rather than a modelBeing tested at scale · 26 connectionsDiscussstart a thread
• Group trials by broken mechanism, not by organ or single mutationEarly clinical · 25 connectionsDiscussstart a thread
• Harmonise PD-L1 testing for triple-negative breast cancer around one scored assay, with external quality assuranceEarly clinical · 25 connectionsDiscussstart a thread
• Make resistance a diagnosis: sequence at every progression and choose the next line from what the tumour becameEarly clinical · 25 connectionsDiscussstart a thread
• Patient-level multimodal foundation models for treatment selectionPreclinical evidence · 25 connectionsDiscussstart a thread
• Surveillance for every germline carrier found by universal testing, inside a registry rather than a research exceptionBeing tested at scale · 25 connectionsDiscussstart a thread
• Treat lung cancer in never-smokers as its own disease, with its own detection programmePreclinical evidence · 25 connectionsDiscussstart a thread
• Use LET, RBE and alpha/beta to decide when protons beat IMRTPreclinical evidence · 25 connectionsDiscussstart a thread
• Use pre-surgery immunotherapy windows as the field's biomarker engineBeing tested at scale · 25 connectionsDiscussstart a thread
• Find out what is driving early-onset bowel cancer, starting with colibactin, before extending screening any furtherPreclinical evidence · 24 connectionsDiscussstart a thread
• Off-the-shelf KRAS vaccines after pancreatic cancer surgeryEarly clinical · 24 connectionsDiscussstart a thread
• Prevention trials aimed only at brain metastasisSpeculative · 24 connectionsDiscussstart a thread

All ideas, filterable by maturity, actor and cost: /ideas/.