Phase III

Oncology

pain 92#6volume 3,823#4

Pain rank 6 of 76, volume rank 4 of 76 by industry trials. Trials here amend about 1.5x and fail enrollment about 1.8x 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 62 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 $28M at stake per 100 trials. Across the roughly 3,823 industry trials here, the floor is $1.1B.

If amendments fell by10%$106M30%$318M50%$530M

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 A trial counts as concluded once it has finished, whether completed, terminated or withdrawn.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 sponsors92pain index
Eligibility amendments
62%vs map 40%proxyn = 229sampled
Enrollment failure
24%vs map 13%n = 2,309concluded
Startup lag
68 dvs map 45.5 dn = 2,675with dates
Median duration
37.3 mon = 3,646completed
All sponsors90pain index
Eligibility amendments
57%proxyn = 317sampled
Enrollment failure
21%n = 5,434concluded
Startup lag
76 dn = 5,711with dates
Median duration
45.0 mon = 9,659completed
Why these trials stoppedsponsor decision leads

The most common category here is sponsor decision (155 of 546 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.

Sponsor decision155 (28%)
Low accrual94 (17%)
Not reported80 (15%)
Efficacy or futility72 (13%)
Safety or tolerability52 (10%)
Other stated reason16 (3%)
No enrollment recorded (inferred)inferred15 (3%)
External or regulatory14 (3%)
Business or funding10 (2%)
Superseded by another study9 (2%)
Logistics or operations9 (2%)
Feasibility or operational failure5 (1%)
Completed or objective met4 (1%)
Change in standard of care4 (1%)
Technical or device issue4 (1%)
Investigator decision or departure2 (0%)
Never initiated1 (0%)
n = 546terminated or withdrawn
Evidence12 trials

A sample of terminated or withdrawn trials in this cell.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

TrialSponsorStatusStated reason
NCT07551544ImmunityBio, Inc.withdrawnSponsor decision
NCT07524257ImmunityBio, Inc.withdrawnSponsor decision
NCT07428369Regeneron PharmaceuticalswithdrawnSponsor decision
NCT07342517Relmada Therapeutics, Inc.withdrawnSponsor decision
NCT07313891Relmada Therapeutics, Inc.withdrawnSponsor decision
NCT07084909Lantheus Medical ImagingwithdrawnLow accrual
NCT06884254EirGenix, Inc.withdrawnExternal or regulatory
NCT06795191Foresee Pharmaceuticals Co., Ltd.withdrawnSafety or tolerability
NCT06795178Foresee Pharmaceuticals Co., Ltd.withdrawnSafety or tolerability
NCT06643117Formycon AGterminatedCompleted or objective met
NCT06587451SandozterminatedExternal or regulatory
NCT06513884Hookipa Biotech GmbHwithdrawnSponsor decision

Oncology at other phases