alt Hacker NewsIndeed, 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!
Jet engine design is iterative, and the basic principles are well-understood.
Drug design seems a lot more binary. You can find a new pathway, but drugs themselves are fairly simply molecules, and you can't iteratively 'fix bugs' the way you can in an engine or a piece of software.
The engine is a given, it's almost astronomically complicated, you know a lot less about how it works than you'd like to, and you're trying to change how it works while it's running without breaking anything, using tiny rigid parts that have to snap into place correctly and can't be bent to fit.
High failure rates aren't surprising.