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The recommendations in the document are divided into four categories: trial design and data analysis, patient and site recruitment, comparators, and outcomes.
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Seems to me the more fundamental concern with respect to off label use for cancer is
funding trials. Consider Metformin..dirt cheap/generic available, pretty safe..and no way to capitalize on/recoup cancer trials in a normal pharma sense. It's already on the market as a cheap drug..hard to call it by another name and charge 2,000% more.