This annual report assesses the trends in new drug approvals and launches, overall pipeline activity, the number of initiated clinical trials, the status of R&D funding, and more.

Key findings for 2025

R&D funding has increased

• Biopharma funding increased for the second consecutive year
• Total large pharma R&D spending continued to increase

Clinical trial start volumes have stabilized

• Trial starts have fully returned to pre-pandemic levels
• Priorities have continued to shift

Clinical program productivity has increased

• Assessed using refreshed Clinical Program Productivity Index (CPPI)
• Improvement driven by success rate increase in Phase III

Cycle times are stabilizing

• Enrollment duration – the largest opportunity to improve trial cycle times – stabilized in 2024 after having increased between 2021 and 2023
• Inter-trial intervals now typically account for 17 months of total development time across an R&D program; this figure has improved greatly since the 2022 peak of 32 months seen at the height of the pandemic

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