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Instead of a new trial for each resistance mechanism, one continuous trial could sort patients into arms based on the reason their last treatment failed.
A perpetual master protocol with a common progression-biopsy and plasma workup, a shared control arm and arms opened and closed as mechanisms and matched agents emerge. This shares infrastructure across sponsors, gives patients a reason to have the biopsy, and produces mechanism-specific efficacy estimates that no single-sponsor trial can. Precedents include Lung-MAP and I-SPY in other settings.
Shares Basket, umbrella, and platform trials, Trial modernisation roadmap: the randomised trial → platforms and adaptive designs → decentralised, pragmatic and always-on, Trials enrol too few, too slowly, Trial design, endpoints and cost.
Shares Basket, umbrella, and platform trials, Trial modernisation roadmap: the randomised trial → platforms and adaptive designs → decentralised, pragmatic and always-on, Trial design, endpoints and cost.
Shares Basket, umbrella, and platform trials, Trial modernisation roadmap: the randomised trial → platforms and adaptive designs → decentralised, pragmatic and always-on, Trials enrol too few, too slowly, Trial design, endpoints and cost.
Shares Basket, umbrella, and platform trials, Trials enrol too few, too slowly, Trial design, endpoints and cost.
Shares Acquired resistance to every therapy, Comprehensive genomic profiling, Liquid biopsy (ctDNA).
Shares Trial modernisation roadmap: the randomised trial → platforms and adaptive designs → decentralised, pragmatic and always-on, Trials enrol too few, too slowly.
Shares Acquired resistance to every therapy, Comprehensive genomic profiling, Liquid biopsy (ctDNA).
Shares Trials enrol too few, too slowly, Comprehensive genomic profiling, Liquid biopsy (ctDNA).