Phase IV

Oncology

pain 78#16volume 464#49

Pain rank 16 of 76, volume rank 49 of 76 by industry trials. Trials here amend about 1.1x and fail enrollment about 1.4x 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 46 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 $21M at stake per 100 trials. Across the roughly 464 industry trials here, the floor is $96M.

If amendments fell by10%$10M30%$29M50%$48M

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 A trial counts as concluded once it has finished, whether completed, terminated or withdrawn.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 sponsors78pain index
Eligibility amendments
46%vs map 40%proxyn = 48sampled
Enrollment failure
19%vs map 13%n = 366concluded
Startup lag
69 dvs map 45.5 dn = 233with dates
Median duration
32.7 mon = 431completed
All sponsors60pain index
Eligibility amendments
34%proxyn = 92sampled
Enrollment failure
19%n = 1,140concluded
Startup lag
64 dn = 1,025with dates
Median duration
29.1 mon = 1,980completed
Why these trials stoppedlow accrual leads

The most common category here is low accrual (23 of 69 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 accrual23 (33%)
Not reported18 (26%)
Sponsor decision11 (16%)
No enrollment recorded (inferred)inferred4 (6%)
Superseded by another study3 (4%)
External or regulatory3 (4%)
Logistics or operations2 (3%)
Business or funding2 (3%)
Technical or device issue1 (1%)
Efficacy or futility1 (1%)
Other stated reason1 (1%)
n = 69terminated or withdrawn
Evidence12 trials

A sample of terminated or withdrawn trials in this cell.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

TrialSponsorStatusStated reason
NCT06390111Ferring PharmaceuticalswithdrawnSponsor decision
NCT05900908GT Medical Technologies, Inc.withdrawnSuperseded by another study
NCT05853458Novartis PharmaceuticalsterminatedSponsor decision
NCT05583188Galvanize Therapeutics, Inc.terminatedSponsor decision
NCT05183139TakedawithdrawnLow accrual
NCT05061654Hamad Medical CorporationwithdrawnSponsor decision
NCT04506086AmgenterminatedLow accrual
NCT04381494AstraZenecaterminatedLow accrual
NCT04031885Eli Lilly and CompanyterminatedLow accrual
NCT03988114Eli Lilly and CompanywithdrawnSponsor decision
NCT03971110AstraZenecaterminatedLow accrual
NCT03460678Hikma Pharmaceuticals LLCterminatedLow accrual

Oncology at other phases