Phase 2 attrition jumps amid widespread scale-back in overall clinical trial activity: study

The wave of pipeline prioritization initiatives implemented last year has shown up in the data, with Phesi tracking a jump in terminations of phase 2 clinical trials and a fall in activity in certain major therapeutic areas. 

Researchers at the data analytics provider assessed 80,917 trial records to generate the insights. The analysis revealed a rise in phase 2 terminations. Last year, the midphase attrition rate hit 28%, an increase of 42% over the average across the previous five years. The attrition rate comfortably exceeded the spike seen in 2020, when the impact of COVID-19 on clinical trials drove an uptick in the termination of studies. 

The rise in phase 2 attrition is part of a broader scale-back in activity evident in the data. Phesi President Gen Li, Ph.D., outlined the areas in which clinical trial activity fell in 2022 in a statement to disclose the analysis. 

“With an increase in available vaccines and therapies, it is not surprising that the number of recruiting trials for COVID-19 therapies has fallen,” Li said. “However, the reduction in breast cancer trials is unexpected, with 113 fewer recruiting trials in 2022 compared with 2021. This demonstrates the pressures facing the clinical development industry as the consequences from several years of disruption become visible.” 

Breast cancer remained the most studied indication, but the number of clinical trials fell from around 900 in 2021 to below 800 last year. Other indications fell out of the top five most studied diseases altogether. 

In 2021, non-small cell lung cancer and multiple myeloma occupied the third and fifth spots on the list of most studied indications. Last year, the diseases were replaced by prostate cancer and stroke, respectively. With solid tumor retaining the fourth spot, the list remains dominated by oncology indications despite the changes. 

The Phesi analysts think the downturn in clinical trial activity and specifically the phase 2 attrition “are likely to have an ongoing effect on the clinical development industry and may slow the rate at which new therapies reach market, or even prevent viable new therapies from ever reaching patients.” The changes cover a year in which drug developers, notably loss-making biotechs, cut back amid financial pressures.