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Rather than building a new trial from scratch for every drug, keep one permanent trial open per cancer where new treatments can be slotted in and dropped out, sharing the same patients, control group and infrastructure.
Perpetual multi-arm platform trials with a common control, Bayesian adaptive randomisation and pre-agreed arm entry and graduation rules, as in I-SPY 2 (breast), STAMPEDE (prostate) and GBM AGILE (glioblastoma). The proposal is to fund the fixed infrastructure (governance, sites, data, statistics) for each of the ten commonest cancers as a public or philanthropic good, with sponsors paying a per-arm fee.
Shares Basket, umbrella, and platform trials, Trial modernisation roadmap: the randomised trial → platforms and adaptive designs → decentralised, pragmatic and always-on, Too many combinations to test, 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, Too many combinations to test, Trials enrol too few, too slowly, Pancreatic ductal adenocarcinoma.
Shares Basket, umbrella, and platform trials, Trials enrol too few, too slowly, Trial design, endpoints and cost, Pancreatic ductal adenocarcinoma.
Shares Randomise the order of treatment, not only the drugs: a strategy platform for metastatic prostate cancer, Prostate cancer roadmap: from Huggins and the discovery that a cancer can depend on a hormone, through the PSA epidemic and what it cost, the androgen receptor drugs, the DNA repair subset and PSMA, to a 2032 registry watch, Trial design, endpoints and cost, Prostate cancer.
Shares Basket, umbrella, and platform trials, Trial modernisation roadmap: the randomised trial → platforms and adaptive designs → decentralised, pragmatic and always-on, Too many combinations to test, Trial design, endpoints and cost.
Shares Basket, umbrella, and platform trials, Too many combinations to test, Trial design, endpoints and cost, Glioma & glioblastoma.
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.