This report assesses trends in R&D funding, clinical trial activity, new drug launches and clinical productivity, while examining key efficiency enablers at sponsor and ecosystem level.

Key findings for 2026

• R&D funding levels were high in 2025 but lower than in 2024:
• Biopharma funding and large pharma R&D expenditure slowed, but remained well-above pre-pandemic levels
• R&D deals between biopharma companies rose, while deals between China-headquartered and international companies reached an all-time high
• Clinical trial starts were increasingly concentrated among U.S. sponsors:
• Trial starts increased for U.S.-headquartered sponsors and for those in Japan
• Trial starts from China-headquartered and Europe-headquartered sponsors declined
• The number of novel active substance (NAS) launches increased on a global basis:
• Thirty launches were global first-in-class
• Thirty were launched only in China
• Improved clinical program productivity was not sustained:
• Trial durations increased overall, with faster enrolment in oncology countered by its higher representation among trials completing enrolment
• Inter-trial intervals increased by 3 months
• Sponsors and regulators are taking steps to enable efficient development
• Acceleration activities have been prominent among regulatory agencies
• Artificial intelligence increasingly enabled R&D, manifesting in increased success rates among AI-driven programs

This annual report profiles the current state of research and development in oncology, including key mechanisms, targets and cancer types being investigated, as well as pointing to some novel areas which are only just emerging and clinical development productivity.

Key Findings:

Oncology R&D activity continues to grow driven by novel modalities:

• Oncology trials starts increased slightly in 2024 to 2,162, following declines after a peak in 2021, and are up 12% from the number of trials started in 2019, primarily focused on rare cancers and solid tumors.
• Novel oncology modalities, especially cell and gene therapies, antibody-drug conjugates (ADCs), and multispecific antibodies, now account for 35% of oncology trials

Oncology continues to see significant novel medicine launches:

• Twenty-five oncology novel active substances (NAS) were launched globally in 2024, and the average number of new launches annually from 2020–2024 was 26 compared to an average of 16 in the five years prior
• A total of 132 oncology NAS have launched globally in the past five years and 282 over 20 years with large geographic variations, including a notable acceleration in launches in China since 2019

Spending on oncology medicines is growing across geographies and tumors:

• Cancer medicine spending at list prices rose to $252Bn globally in 2024 and is expected to reach $441Bn by 2029
• Double-digit spending growth is forecasted for seven of the top 10 tumors, all areas with significant numbers of breakthrough new medicines, though biosimilar competition for PD-1/PD-L1 inhibitors will slow growth across many of these tumors in 2028 and 2029