Beyond early discovery, LLMs deliver significant value in clinical trials. They accelerate timelines by automating months of post-trial documentation work. More strategically, they can improve trial success rates by analyzing genomic data to identify patient populations with a higher likelihood of responding to a treatment.

A multi-center study revealed patients receiving glucarpidase were inherently sicker with more severe kidney injury. This selection bias means simple comparisons are misleading; only after adjusting for these factors does the drug's significant benefit in kidney recovery become clear.

Beyond immediate kidney rescue, glucarpidase's crucial role is preserving a patient's eligibility for subsequent methotrexate cycles. This allows them to complete their planned, first-line cancer treatment, giving them the best chance at remission—a benefit not captured by short-term outcomes.

The Uromigos score (0-3) provides a rapid expert consensus on new treatments. It bridges the gap between slow, formal guidelines and long, unprioritized lists of approved therapies, offering a more immediate assessment of a drug's place in the standard of care.

The traditional drug-centric trial model is failing. The next evolution is trials designed to validate the *decision-making process* itself, using platforms to assign the best therapy to heterogeneous patient groups, rather than testing one drug on a narrow population.

Clinical evidence suggests a critical 48- to 60-hour window for administering glucarpidase post-methotrexate infusion. Once irreversible organ injury occurs, the drug's benefit is significantly reduced. This narrow timeframe underscores the need for rapid diagnosis and intervention.

With over 5,000 oncology drugs in development and a 9-out-of-10 failure rate, the current model of running large, sequential clinical trials is not viable. New diagnostic platforms are essential to select drugs and patient populations more intelligently and much earlier in the process.

The placebo effect in gastrointestinal treatments is remarkably high, around 35-40%. This makes subjective patient feedback unreliable for assessing a therapy's true effectiveness and underscores the urgent need for objective, data-driven measurement tools.

Clinicians can avoid treatment delays and unnecessary fluid administration by having patients start sodium bicarbonate before hospital admission. This proactive strategy ensures the patient's urine is appropriately alkalized, allowing high-dose methotrexate to be administered safely and on schedule.