Biomedical progress in therapeutics has been hindered despite advances in basic science, a trend known as Eroom's Law. The Clinical Trial Abundance Project aims to enhance the efficiency and informativeness of clinical trials, arguing that learning from both successes and failures is crucial for developing new therapies, as exemplified by the evolution of CAR-T cell therapies.

• Inflation-adjusted drug development costs have doubled roughly every 9 years since the 1950s (Eroom's Law), even as basic science has advanced.
• Clinical trials shouldn't just validate existing hypotheses—they should function as an active discovery engine, with failures generating insights that improve subsequent trial designs.
• CAR-T therapy's eventual success (e.g., Kymriah's FDA approval via the ELIANA trial) came only after nearly two decades of iterative trial failures that progressively refined understanding of T cell responses.
• Making trials faster and more efficient isn't in tension with generating better drug hypotheses—the two goals are complementary and can reinforce each other in a positive feedback loop.