original process of informed consent, to make sure the participants are properly aware of the reasons for the redesign and the scientific value of the new study. Here, the redesign was driven by the cessation of manufacture of the drug, but likewise a public funder might withdraw support for a study midstream due to a change in policy or a re-assessment of the evidence value for the healthcare system. Often, it is just as valuable to know with good precision that an intervention doesn’t work, particularly if it is expensive or associated with considerable side-effects. Most importantly, we must do everything we can as clinical trialists to reassure the patients and the public that their participation is always considered with the utmost care and constant vigilance around the emerging risk–benefit ratio, and never taken for granted. To get patients to participate in research is already challenging, and we are too permissive of stakeholders changing their minds midstream. This issue could be avoided by requiring all stakeholders to commit to seeing the study through, backed by the required resources to complete this study (and with adequate insurance cover for the case of commercial failure), with subsequent changes to design only occurring through agreed scientific criteria mediated through appropriate statistical procedures. We owe participants this protection to properly safeguard their contribution, as well as improving the scientific yield of our trials. Interestingly, after the initial conference presentation1 of the potentially positive findings in 2013, and more recent promising early phase findings, 9 interest from AstraZeneca appears to have been rekindled, and after company review of the outcomes and survival methods, the possibility now exists of using these data for regulatory submission. However, these data will obviously be less convincing for that purpose than if the trial had continued under its original design—in terms of evidence of effectiveness, safety, and acceptability. It appears to us that now this situation has been fully played out, no one has gained any advantage from the 2011 decision to stop manufacturing cediranib. We should try hard to make sure—particularly for the sake of patients—that this type of avoidable problem isn’t allowed to happen again.