OnCo
ideasIdea

Make post-progression sampling a condition of accelerated approval

Drugs approved on early evidence come with follow-up obligations. One of them should be finding out how tumours escape the new drug.

Accelerated approvals already carry confirmatory trial requirements. Adding a resistance-characterisation commitment (a specified number of paired progression samples with mechanism reporting into a public database within a defined period) would ensure the field learns how each new agent fails while the drug is still early in its lifecycle, rather than a decade later.

Hypothesis
Approval-linked sampling commitments produce mechanism data for new agents years earlier than the status quo and demonstrably shape the design of successor agents and combinations.
Rationale
Post-marketing requirements are an established regulatory instrument and are already used for dose optimisation under Project Optimus; the incremental cost to a sponsor is small relative to the value of the information.
What would test it
Apply the requirement to a small number of new approvals as a pilot and compare time-to-first-published-mechanism with matched historical approvals.
Maturity
speculative
Who has to act
regulator
Cost to try
Small (under $1M)
Years to first evidence
5
Bottlenecks it attacks

Connected

5top