The oddness of the research program finally got through to me: a lot of those exploratory trials would traditionally have been done as investigator-sponsored p2s. The company has some specific ideas that it wants to investigate, and it makes sense that they wouldn't wait to find oncs who were enthusiastic enough about those ideas to take the lead. And to be sure, some of them are practically mini-p3s, with a chance of selling something fairly quickly if the trial succeeds. But still and all, combination regimens and same drug / different tumor extensions have come as often from the trenches as from the main office.
Am I missing the investigator stuff? Has care management by insurance providers dampened initiative? Are the ideas just too novel for practitioners to be pushing them forward yet? Or maybe I'm longing for the return of a past that never was (Bierce?) and investigator sponsored p2s were never as bold as I think.