The examples you have shown had marginal results in the small studies to start with. Find me an example of where there has been 10 times outperformance i.e 8% vs 88% survival and then it failed in the larger trial. The point I have repeated a few times now is that the bar is very low, atm. I would argue there are almost no treatments for ARDS as even the ventilators have such a low success rate that it is effectively a death sentence.
Nothing is guaranteed. If you want the guaranteed results at the end of the rainbow, they have huge premiums.
Ann: 83% Survival in COVID-19 ARDS Patients with Remestemcel-L, page-501
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