This is completely unsurprising, and this:
But let’s think about that 91% failure rate for a moment. When I bring this up in presentations, I invite the audience to consider what the auto industry would look like of 91% of new car designs proved unable to roll out of the factory, or if 91% of new airliner models were unable to leave the ground
Is an utterly irrelevant comparison. For physical thing we have engineering, and the practical application of the trades and craft, trial and error.
For modern medicine, we're only just starting to come out of the wild west era. Or perhaps slightly further along than that.
Indeed, I suspect the failure rate of, say, new jet engine designs is rather high as well -- those failures just never get reported in a federal repository, unlike RCTs, since they never make it out of the simulator or the prototyping lab. And we have, comparatively, much better computational models of how airplanes fly than how cancer cells mutate. FWIW this clinical stat is far better than Edison's supposed lightbulb-idea failure rate!
> For modern medicine, we're only just starting to come out of the wild west era. Or perhaps slightly further along than that.
Why do you say that? What's the evidence? We continue to have virtually no clue how to make drugs, per TFA.