Evidence map›Paper›PMID 39994861›Full record

ArticleJournal of the National Cancer Institute2025

Proportion of patients in phase 2 oncology trials receiving treatments that are ultimately approved.

Charlotte Ouimet, Bianca Fodor, Joseph C Del Paggio, Jonathan Kimmelman

Abstract read
In one paragraph

Article in Journal of the National Cancer Institute, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Charlotte OuimetDepartment of Equity, Ethics and Policy, McGill University School of Population and Global Health, Montreal, QC H3A 1G1, Canada.ORCID 0000-0001-5465-2256
Bianca FodorDepartment of Equity, Ethics and Policy, McGill University School of Population and Global Health, Montreal, QC H3A 1G1, Canada.ORCID 0009-0005-4754-5408
Joseph C Del PaggioDepartment of Oncology, Thunder Bay Regional Health Sciences Centre and Northern Ontario School of Medicine University, Thunder Bay, ON P7B 6V4, Canada.ORCID 0000-0001-5281-2746
Jonathan KimmelmanDepartment of Equity, Ethics and Policy, McGill University School of Population and Global Health, Montreal, QC H3A 1G1, Canada.ORCID 0000-0003-1614-6779

Funding

CIHRCIHR PJT-175217Navigating the Valley of Death
6 · The paper itself

Abstract

backgroundMany patients enroll in phase 1 dose expansion cohorts or phase 2 clinical trials (together referred to below as "phase 2") seeking access to novel treatments. Little is known about the extent to which they benefit by enrolling. Herein, we use a novel metric of benefit-therapeutic proportion-to assess the probability that patients in phase 2 trials receive treatment that eventually advances to FDA (Food and Drug Administration) approval for their condition.

methodsWe randomly sampled 400 trials identified in a search of Clinicaltrials.gov for cancer phase 2 trials initiated between November 1, 2012 and November 1, 2015. We determined whether the drug/dose/indication tested in each trial advanced to FDA approval within 7.5 years. We determined whether the drug/dose/indication presented substantial clinical benefit using the ESMO-MCBS (European Society for Medical Oncology - Magnitude of Clinical Benefit Scale), or whether it received off-label recommendation in NCCN (National Comprehensive Cancer Network) guidelines.

resultsCollectively, trials in our sample enrolled 25 002 patient-participants in 608 specific treatment cohorts. A total of 4045 patients received a treatment that advanced to FDA approval (16.2%; 95% CI = 10.3 to 22.7). The therapeutic proportion increased to 19.4% (95% CI = 14.1 to 25.8) when considering NCCN off-label recommendations and decreased to 9.3% (95% CI = 4.7 to 14.6) for FDA-approved regimens considered being of substantial clinical benefit by ESMO-MCBS. Bootstrap test of mean difference showed no statistical difference in proportions based on drug class, trial phase, or sponsorship.

conclusionOne in 6 patients in phase 2 clinical trials receives treatments that are eventually approved. This represents a higher therapeutic value than phase 1 trials.

Indexed as

Antineoplastic AgentsClinical Trials, Phase II as TopicDrug ApprovalNeoplasmsHumansMedical OncologyUnited StatesUnited States Food and Drug AdministrationAntineoplastic Agents

Identifiers

PMID39994861
PMCPMC12058269

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.