OnCo
ideasIdea

A registry of every treatment sequence patients actually receive, with outcomes

Record, for every patient, the order of treatments and what happened, so that the most common sequences can be compared and the worst ones flagged.

Approved drugs multiply faster than sequencing trials. A national or multi-centre registry capturing line-by-line therapy and outcomes (as the Flatiron and Dutch cancer registries partly do) with a public dashboard of sequence performance would let clinicians see which sequences are common and which look poor, and give trialists the effect sizes needed to design randomised sequence trials.

Hypothesis
Publishing sequence-level outcomes will change prescribing away from the bottom-quartile sequences within two years, measurable as a fall in their share of use.
Rationale
Registry feedback changed practice in cardiac surgery and in Dutch colorectal cancer care. The data already exists; it is not assembled by sequence.
What would test it
Build the dashboard for metastatic breast and colorectal cancer in one health system; publish; measure change in sequence shares.
Maturity
early clinical
Who has to act
data
Cost to try
Medium ($1M to $50M)
Years to first evidence
3
Bottlenecks it attacks

Connected

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