The following article features coverage from the European Society for Medical Oncology 2020 virtual meeting. Click here to read more of Cancer Therapy Advisor‘s conference coverage.

More clinical trials are conducted in Western European countries compared with Eastern or Central Europe, signaling differences in access to novel therapies for European patients with cancer, according to results of a study presented at the European Society for Medical Oncology (ESMO) Virtual Congress 2020.1

“Having access to clinical trials confers several benefits to cancer patients. It means they

can potentially access novel therapies earlier during the trial phase rather than having to wait for licensing and reimbursement,” Teresa Amaral, MD, of the University Hospital Tubingen in Germany, and coauthor of the study, said in a press release.2

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The study searched the database for interventional, phase 1 to phase 3 trials between 2009 and 2019 that were registered in Europe.1 A single trial could be registered in multiple countries; each registration was considered a single trial entry.

There were 5787 unique clinical trials with 18,454 registrations identified. The majority were phase 3 at 44%, followed by 32% that were phase 2, 13% that were phase 1, 9% that were phase 1/2, and 2% that were phase 2/3. Most were industry sponsored.

More trials were registered in Northern Europe, with 5.33 per 100,000 inhabitants compared with 2.48 per 100,000 inhabitants in Central/Eastern Europe. The lowest proportion of trials was conducted in Albania at 0.14 per 100,000 inhabitants, whereas the highest was 10.7 per 100,000 inhabitants in Belgium.

Southern and Western Europe had higher rates of phase 1/2 trials at 13% to 15% compared with 4% to 9% in Central, Eastern, and Northern Europe.

Overall, there was a 33% increase in the number of trials conducted in Europe between 2010 and 2018, which included a 61% increase in early-phase trials compared with a 7% increase in later-phase trials. However, multiple countries experienced a decrease in clinical trials, particularly those located within the Eastern region.

The number of trials per 100,000 inhabitants was correlated with gross domestic product, although there were outliers. The number of trials was also moderately correlated with cancer incidence.

The difference in the number of clinical trials across European countries signals a disparity in access to novel treatments for patients with cancer.

“The difference in the number of clinical trials per head of population, with more trials in wealthier countries, means access to clinical trials and innovative drugs is just not possible for cancer patients living in many less wealthy countries,” Thomas Cerny, Professor of medical oncology at the University of Berne, Switzerland and member of the ESMO Principles of Clinical Trials and Systemic Therapy Faculty, said.

Read more of Cancer Therapy Advisor‘s coverage of the ESMO Virtual Congress 2020 by visiting the conference page.


  1. Carneiro A, Amaral TMS, Brandao M, et al. Disparities in access to oncology clinical trials in Europe in the period 2009-2019. Presented at: European Society for Medical Oncology (ESMO) Virtual Congress 2020; September 19-21, 2020. Abstract LBA66_PR.
  2. European Society for Medical Oncology (ESMO). Access to cancer medicines and clinical trials show stark variations across Europe [press release]. Published September 18, 2020. Accessed September 21, 2020.