Escalating conflict between Israel, Iran and the US had a marked impact on clinical trial initiations in Q2 2025.
While China continued to dominate clinical trial activity outside of North America and Europe in Q2, analysis by GlobalData shows that India has overtaken Iran in Q2 2025 trial initiations, potentially driven by the Iran-Israel conflict. GlobalData’s latest report reveals that Iran had 348 trials initiated in Q2, compared to India with 944.
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A report published by GlobalData in January 2025 showed China had overtaken the US in industry-sponsored clinical trials for innovator drugs in 2024. Most of these studies, however, are single-country trials, so they would likely create a barrier to market entry if companies were seeking approval in the US or European markets.
China’s clinical trials footprint is expanding, in part due to lower costs compared to countries such as the US. Rising trial costs are an issue impacting sponsors worldwide. The increase in costs is likely due to the need for more qualified staff, complex trial designs, and material costs, especially considering the impact of Trump’s tariffs.
Oncology remains lead disease area
On a global scale, oncology was the leading therapeutic area of focus, with 1,674 oncology-related trials either launched or scheduled to commence in Q2 2025. Central nervous system (CNS) studies were a close second with 1,521 trials scheduled and initiated in Q2.
Compared to the same time in 2024, there was a rise in both oncology and CNS initiations, where 1,637 and 1,429 trials were recorded, respectively.
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By GlobalDataWithin oncology, solid tumours dominated the landscape with 1,360 trials, while pain management emerged as the most studied indication in the CNS category, boasting 772 trials.
GlobalData’s senior pharma product manager Kathryn Kinch said: “AstraZeneca led among large- and mega-cap sponsors of drug trials. Oncology trials dominated the landscape, making up the largest share of new trials, with solid tumours as the most studied indication and pain leading in central nervous system research.”
The report also identifies the top ten trial sites in North America, Europe, and the rest of the world based on the number of trials initiated.
The CRO Activity and Intel report is published on a quarterly basis. The data presented in this report reflects the database as of 10 July 2025.
GlobalData is the parent company of Clinical Trials Arena.
