OnCo
ideasIdea

Living systematic reviews of animal and organoid evidence before every new trial

Before testing a drug in people, someone should systematically gather all the animal and laboratory evidence, including the studies that failed. Almost no cancer trial does this.

CAMARADES and the SYRCLE group have shown that systematic review and meta-analysis of preclinical studies reveals publication bias, small-study effects and true effect sizes far below those in the headline papers. Requiring a registered, continuously updated systematic review of preclinical evidence (with automated literature surveillance) as part of any trial protocol or ethics application would ground trial decisions in the whole evidence base.

Hypothesis
Preclinical living reviews will reveal substantial publication bias (funnel asymmetry) for at least half of therapeutic hypotheses entering trials, and will change the decision to proceed or the trial design in at least a fifth of cases.
Rationale
Systematic review is the standard for clinical evidence; its absence for preclinical evidence means trials are launched on a biased sample of results.
What would test it
Produce living reviews for twenty hypotheses entering phase 1; report bias metrics and document whether the review changed any decision.
Maturity
early clinical
Who has to act
research
Cost to try
Medium ($1M to $50M)
Years to first evidence
2
Bottlenecks it attacks

Connected

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