Phase II

General & cross-cutting

pain 75#17volume 850#31

Pain rank 17 of 76, volume rank 31 of 76 by industry trials. Trials here amend about 1.0x and fail enrollment about 1.6x the map median.

What this is worth

The amendment proxy, priced. Order of magnitude, anchor cited, assumptions on the table.

Per 100 industry trials in this cell, about 40 rewrite their eligibility criteria at least once. At the industry average of $450k direct cost per amendment, with the 6+ weeks of delay each not even counted, that is at least $18M at stake per 100 trials. Across the roughly 850 industry trials here, the floor is $155M.

If amendments fell by10%$15M30%$46M50%$77M

Assumes $450k direct cost per amendment (industry average; Phase II median runs lower, Phase III higher, and delay cost is excluded), applied to the proxy rate. The proxy counts only trials with at least one eligibility change, so this understates the true exposure. How this is derived.

The signals

Industry sponsors first, since that is the commercial buyer, each figure shown against the map median. All-sponsor figures follow. A trial counts as concluded once it has finished, whether completed, terminated or withdrawn.

Industry sponsors75pain index
Eligibility amendments
40%vs map 40%proxyn = 42sampled
Enrollment failure
21%vs map 13%n = 656concluded
Startup lag
70 dvs map 45.5 dn = 467with dates
Median duration
15.9 mon = 823completed
All sponsors73pain index
Eligibility amendments
35%proxyn = 82sampled
Enrollment failure
19%n = 2,020concluded
Startup lag
81 dn = 1,536with dates
Median duration
20.0 mon = 3,031completed
Why these trials stoppedlow accrual leads

The most common category here is low accrual (33 of 140 stopped). A keyword pass runs first; free text it could not place was sorted once by a frozen AI classification into these same categories, auditable rather than a live model. "No enrollment recorded (inferred)" is not a stated reason: it is read from a zero enrollment count, meaning the trial never enrolled anyone. "Not reported" means the sponsor left the field blank, shown rather than hidden.

Low accrual33 (24%)
Sponsor decision28 (20%)
Safety or tolerability23 (16%)
Efficacy or futility13 (9%)
Not reported12 (9%)
No enrollment recorded (inferred)inferred8 (6%)
Business or funding7 (5%)
Logistics or operations4 (3%)
Completed or objective met3 (2%)
Feasibility or operational failure2 (1%)
External or regulatory2 (1%)
Superseded by another study1 (1%)
Technical or device issue1 (1%)
Other stated reason1 (1%)
Never initiated1 (1%)
Change in standard of care1 (1%)
n = 140terminated or withdrawn
Evidence12 trials

A sample of terminated or withdrawn trials in this cell. Each links to its ClinicalTrials.gov record.

TrialSponsorStatusStated reason
NCT06682234Gilead ScienceswithdrawnLow accrual
NCT06531395Kiniksa Pharmaceuticals International, plcterminatedSponsor decision
NCT06219733MedPacto, Inc.withdrawnSponsor decision
NCT06078566Auregen Biotherapeutics, SAterminatedSponsor decision
NCT06072040Auregen Biotherapeutics, SAterminatedSponsor decision
NCT05846659ImmuneSensor Therapeutics Inc.terminatedSponsor decision
NCT05726682SanofiwithdrawnSafety or tolerability
NCT05667662Pulmatrix Inc.terminatedLow accrual
NCT05666453SK Plasma Co., Ltd.terminatedSponsor decision
NCT05612633Samus Therapeutics, Inc.withdrawnBusiness or funding
NCT05568225Forma Therapeutics, Inc.terminatedEfficacy or futility
NCT05394857Suzhou Suncadia Biopharmaceuticals Co., Ltd.terminatedBusiness or funding

General & cross-cutting at other phases