Basket trial health technology assessment requirements and limited access to innovations in oncology: The French paradox.

Competing Interests: Conflict of interest statement The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: AB: as part of the Drug Development Department (DITEP), principal/sub-investigator of clinical trials for AbbVie, Adaptimmune, Adlai Nortye USA Inc, Aduro Biotech, Agios Pharmaceuticals, Amgen, Argen-X Bvba, Arno Therapeutics, Astex Pharmaceuticals, Astra Zeneca Ab, Aveo, Basilea Pharmaceutica International Ltd, Bayer Healthcare Ag, BBB Technologies Bv, Beigene, BicycleTx Ltd, Bioalliance Pharma, Blueprint Medicines, Boehringer Ingelheim, Boston Pharmaceuticals, Bristol Myers Squibb, Ca, Celgene Corporation, Chugai Pharmaceutical Co, Cullinan-Apollo, CureVarc, Daiichi Sankyo, Debiopharm, Eisai, Eisai Limited, Eli Lilly, Exelixis, Faron Pharmaceuticals Ltd, Forma Therapeutics, Gamamabs, Genentech, GlaxoSmithKline, H3 Biomedicine, Hoffmann La Roche Ag, Imcheck Therapeutics, Innate Pharma, Institut De Recherche Pierre Fabre, Iris Servier, Iteos Belgium SA, Janssen Cilag, Janssen Research Foundation, Kura Oncology, Kyowa Kirin Pharm. Dev, Lilly France, Loxo Oncology, Lytix Biopharma As, MedImmune, Menarini Ricerche, Merck Sharp & Dohme Chibret, Merus, Molecular Partners Ag, Nanobiotix, Nektar Therapeutics, Novartis Pharma, Octimet Oncology Nv, Oncoethix, Oncopeptides, Onyx Therapeutics, Orion Pharma, Oryzon Genomics, Ose Pharma, Pfizer, Pharma Mar, Pierre Fabre Medicament, Plexxikon, Roche, Sanofi Aventis, Seattle Genetics, Sotio A.S, Syros Pharmaceuticals, Taiho Pharma, Tesaro, Turning Point Therapeutics, Xencor. Research Grants from Astra Zeneca, BMS, Boehringer Ingelheim, GSK, INCA, Janssen Cilag, Merck, Novartis, Pfizer, Roche, Sanofi. Non-financial support (drug supplied) from Astra Zeneca, Bayer, BMS, Boringher Ingelheim, GSK, MedImmune, Merck, NH TherAGuiX, Pfizer, Roche. AI: advisory board (Bayer, Chugai, Daiichy Sankyo Foundation Medicine, GSK, Roche, Springworks), research grants (Astra Zeneca, Bayer, Chugai, Merck, MSD, Roche) CM: consultant/advisory fees from Amgen, Astellas, Astra Zeneca, Bayer, BeiGene, BMS, Celgene, Debiopharm, Genentech, Ipsen, Janssen, Lilly, MedImmune, MSD, Novartis, Pfizer, Roche, Sanofi, Orion. JYB: research support and honoraria from Roche, Bayer, Deciphera, MSD, BMS, GSK. AM was an investigator in the KN-158 trial (NCT02628067) which provided the rationale for the FDA approval of pembrolizumab in MSI-high and TMB-high tumours and the coordinator of the Acse nivolumab trial (NCT03012581) which contained a cohort of patients with non-CRC MSI-high tumours. AM is the principal investigator of the PEMBIB trial (NCT02856425) where MSD provided free pembrolizumab to Gustave Roussy. Over the last 5 years, AM participated in one scientific advisory board for MSD on a molecule different from pembrolizumab. AM is the principal investigator of a Gustave Roussy pre-clinical project funded by the Foundation MSD Avenir on the immune atlas of cancers.