Lessons from the ECHO chamber
What ECHO-301 can teach us about designing future combo studies
Lessons from the failure of ECHO-301 go beyond the prospects of combining IDO1 and PD-1 inhibition to treat cancer. The broader concern is for the gamut of Phase I/II trials testing PD-1 combinations, many of which will see companies and patients punished for sticking with traditional trial designs rather than adopting novel formats with better chances of predicting Phase III success.
The goal should be to move away from large scale Phase III programs that test combinations in many indications in parallel. Instead, companies should conduct smaller, more focused Phase III programs, only enrolling the patient populations most likely to respond. Early stage trials that use adaptive study designs and include a control arm will likely be key to finding those patients, and finding them quickly...