Breast cancer was the most studied disease in 2023 for the third consecutive year, followed by solid tumours, stroke, Covid-19 and prostate cancer.
The analysis of 65,749 recruiting clinical trials was conducted by data analytics company Phesi, as part of an annual global analysis of clinical trials using data from its Trial Accelerator platform.
Phesi’s analysis also revealed that the US is home to 33% of the 115,000 recruiting investigator sites from interventional trials around the world – with as many sites as the next top seven countries combined.
“The positive news is there has been an increase in trial recruitment across all the top five indications in 2023. What has been especially notable is the increase in solid tumour trials – these are likely to be the foundation of innovative cancer therapies, and investment in this area is a promising sign for patients,” explained Dr Gen Li, President, Phesi. “Meanwhile, we have seen a marked reduction in investment into Covid-19 therapies in 2023, likely due to there being fewer available patients. The prospective market for Covid therapies is less attractive for investment, and we expect to see this downward trend to continue.”
Trials still failing at Phase II
The analysis also revealed that the increased attrition rate at Phase II identified by Phesi’s analysis in 2022 persists. In 2023, 28% of clinical trials were cancelled during Phase II – a rate that averaged around 20% before the pandemic. These high levels of attrition at Phase II may slow the rate at which new therapies reach market and are likely to have an ongoing effect on the clinical development industry, adding to rising costs.
“While there was a slight improvement in cancellation rates in the second half of the year, the data indicate that 2024 will pose further challenges to portfolio managers and trial planners. Ultimately, the clinical development industry is beginning to recover from the pandemic, but we can expect the long-term impact to stretch into 2025,” commented Dr Li. “To minimise the impact of disruption, there is a growing need for trial design and execution to become more data-led. Using predictive analytics in protocol design, simulating trials, and using digital patient profiles will reduce unnecessary amendments, accelerate development and importantly, get therapies to patients faster.”