The article presents innovative designs for early phase clinical trials in oncology as a strategy to accelerate timelines and reduce costs.[1] Adaptive designs allow the trial to be adjusted based on new information, resulting in more accurate recommended dosing for phase II and cost savings.[1] Simulations are used to understand trial behavior, risks and effectiveness, and may be required by regulators to be submitted.[1] Master protocols use a single infrastructure to simultaneously evaluate multiple drugs or disease populations in substudies, accelerating development.[1] In oncology, the probability of success is only 5% after phase I, while the overall success rate of projects is 9.6%.[4] Innovative approaches include seamless phase 1/2, biomarker stratification of patients, and combination strategies to maximize the chances of success.[2][3] Early partnership with protocol design experts and regulatory involvement increases efficiency and regulatory acceptance.[1][2]