Scientists and drugmakers are pioneering a new kind of clinical trial that changes the way cancer drugs are studied, potentially cutting both the time and cost of bringing them to market.
Instead of testing one drug at a time, a novel lung cancer study announced on Thursday will allow British researchers to test up to 14 drugs from AstraZeneca and Pfizer at the same time within one trial.
The aim is to quickly pinpoint medicines that can fight advanced lung cancer by targeting specific rare genetic mutations - and it upends the normal approach of putting a particular drug at the centre of a study.
Harpal Kumar, chief executive of charity Cancer Research UK, which is working on the 25-million-pound ($42-million) project with the two drugmakers, said the new approach would "re-write the rule book on how we do clinical trials".
"We are shifting the emphasis from designing a trial around a specific drug to designing it around selecting from a range of drugs for a specific patient," he told reporters.
The National Lung Matrix trial, which is expected to open in July or August at centres across Britain, is part of a growing trend in cancer research to remodel the way new drugs are tested to keep up with the age of genomic medicine - fine-tuning treatments to the genetic profile of patients.
The U.S. group Friends of Cancer Research said in November it was backing a similar multi-drug, multi-arm clinical trial to evaluate five experimental lung cancer drugs.
Because any single gene mutation behind a particular cancer can be extremely rare, perhaps affecting as few as 1 or 2 percent of patients, studying one drug at a time is extremely challenging.
The new trial offers a way around this by creating a protocol under which scientists can test patients' tumour samples for multiple gene faults and then assign them to an appropriate drug from among those in the trial for testing.
Significantly, it does away with the idea of randomisation, where some patients are given a treatment and others get a "control" substance for comparison - traditionally the gold standard in drug testing.
Increasingly, researchers are questioning whether such randomisation makes sense in patients with incurable cancer if a certain treatment is genetically bound to work much better in some people than others.
Faster, smaller testing could shave years off the usual drug approval process. That also points to lower costs, although firms will be left with small