The challenges of implementing multiarmed early phase oncology clinical trials

In the recent years, drug development in oncology has shifted from classical cytotoxic chemotherapy to the novel molecularly targeted agents (MTAs). With the emergence of MTAs, early phase trials have evolved into complex studies, and trial designs have changed with it. Herein, we address how early phase studies have evolved in the last few years to optimize the process of drug development. We also discuss the challenges that both investigators and institutions have to face as a result of this evolution. Finally, we summarize a number of actions both researchers and research centers may adopt to improve efficiency and rate of late stage trials evolving Phase 1 methodologies.