艾昆纬-2023年全球肿瘤学趋势-展望2027年（英）

Global

OncologyTrends

2023OUTLOOK

TO

2027MAY2

0

2

3IntroductionThe

global

oncology

ecosystem

continues

to

discover,

develop,

and

deliverimportant

novel

treatments

that

are

intended

to

bring

improved

outcomes

for

anincreasing

number

of

patients.

While

this

is

a

strong

testament

to

the

ingenuity

andinnovative

power

of

the

stakeholders

involved,

at

the

same

time

global

oncology

isfacing

complex

challenges

reflected

in

the

trends

highlighted

in

this

report.Ourresearchprofilesthe

currentstate

ofresearchanddevelopmentinoncology,includingkeymechanisms,targets

andcancertypes

beinginvestigatedaswellaspointingtosomenovelareaswhichareonlyjust

emerging.Wealsolookat

metrics

ofclinicaldevelopmentproductivity

andthe

progressbeingmadetoimproverepresentativeness

ofraceandethnicity

inclinicaltrialpopulations.spendingdynamics

willplayout

overthe

next

five

yearsgloballyisalsoexaminedinthisreport.This

study

wasproducedindependentlybythe

IQVIAInstitute

forHumanData

Scienceasapublicservice,without

industry

orgovernmentfunding.The

contributionstothisreport

ofJuliaKern,PenelopePrice,Khushboo

Rastogi,

Tizita

Zelekeandmanyothersat

IQVIA

aregratefullyacknowledged.As

more

novel

cancer

medicines

are

launched,

patientaccess

and

use

of

those

drugs

vary

widely

around

theworld.

Trendsin

the

use

of

novel

mechanisms

in

specificcancer

types

are

reported

here

and

intended

to

providean

evidence

base

that

encourages

stakeholder

discussion.FindOutMoreIfyouwishtoreceivefuture

reports

from

the

IQVIAInstitute

forHumanData

Scienceorjoinourmailinglist,visit

.Finally,the

costs

associatedwith

treatingmorepatientsforlongerandwith

moreadvancedtherapiesisbringingstress

tohealthcarebudgets,

evenasthe

broaderadoptionofbiosimilarsprovides

somerelief.HowtheseMURRAY

AITKENExecutiveDirectorIQVIA

InstituteforHumanDataScience©2023

IQVIA

and

its

affiliates.

All

reproduction

rights,

quotations,

broadcasting,

publications

reserved.

No

part

of

this

publication

may

be

reproduced

ortransmitted

in

any

form

or

by

any

means,

electronic

or

mechanical,

including

photocopy,

recording,

or

any

information

storage

and

retrieval

system,

withoutexpress

written

consent

of

IQVIA

and

the

IQVIA

Institute.Global

Oncology

Trends2023:

Outlook

to

2027Table

of

ContentsOverview14OncologyresearchanddevelopmentactivitiesOncologyclinicaldevelopmentproductivityDiversityandinclusivityinoncologyNovelactive

substancesinoncologyCancerpatientaccessanduseofscientificadvancesSpendingononcologymedicinesNotesonsources16243143566567687072MethodologiesReferencesAbouttheauthorsAbouttheInstituteOverviewGlobal

oncology

R&D

and

innovation

continue

toexpand,

bringing

forward

new

therapies

for

advancedcancers

and

some

of

the

most

advanced

novel

science

inpharmaceutical

development.

These

therapies

representthe

largest

area

of

collective

research

and

the

largestoverall

area

by

drug

spending.

Despite

significant

advancesin

treatment,

the

global

oncology

community

and

patientscontinue

to

struggle

with

disparities

in

access

and

care.The

outlook

for

the

next

five

years

includes

importantcontinuation

of

some

of

these

trends

and

shifts

in

others.ONCOLOGYCLINICAL

DEVELOPMENT

PRODUCTIVITYComposite

success

rates

in

oncology

have

been

trendingdown

since

2015,falling

to

3.5%

in

2022.

Oncology

trialsare

substantially

more

complex

than

other

diseaseareas

when

measured

by

number

of

eligibility

criteria,endpoints,

trial

sites,

countries,

and

clinical

subjects.Oncology

trials

have

significantly

less

“white

space”

—

thedifference

between

the

duration

of

clinical

trials

and

theduration

of

time

between

trial

phases

when

administrativeactivities

often

take

place

—

than

other

therapy

areas

butlonger

trial

duration.

Combining

probability

of

successwith

complexity

and

duration,

overall

productivity

ofoncology

research

is

among

the

lowest

of

all

therapyareas,

though

rare

cancer

productivity

ishigher.ONCOLOGYRESEARCH

AND

DEVELOPMENT

ACTIVITIESOncology

trialstarts

remainedat

historically

highlevelsin2022,up22%

from

2018

andprimarilyfocused

onrarecancers.

Intermsofthesponsors

ofresearch,emergingbiopharmacompanieswereresponsiblefor71%

ofthe

oncologypipelinein2022,upfrom

45%adecadeagoandincreasinglyinvolvedwithout

largerpharmacompanypartners

untillaterinthedevelopmentofanasset,

orevenafter

it

haslaunched.Drugs

from

China-headquartered

companieshaverisen

to23%

oftheoncologypipelinefromonly

5%adecade

ago,andmanyofthese

companieswilllikelypartner

with

multinationalstoreachdevelopedmarkets.DIVERSITY

AND

INCLUSIVITY

INONCOLOGYDisparitiesexist

acrossdemographicgroupsinbothsocioeconomicstatus

andcanceroutcomes,with

12%highermortality

inBlack/African

American

populationsthanotherdemographicgroups.Despitethesedisparitiesindiseaseoutcomes,Black/African

AmericanandHispanicinclusioninoncologyclinicaltrialsisamongthe

lowest

ofallmajortherapeuticareaswith

only

2.8%Black/African

American

and5.9%Hispanicpatientsintrialscompleted2020–2022,80%

and61%

belowtheir2019

U.S.

cancerincidencesof13.8%and15.3%,respectively.

Keyoperationaldecisionscan

impact

trialinclusivity,

includinginclusion/exclusioncriteria,

numberofsubjects,

andtrialsites.Planningacrossthe

entiretriallifecycle

can

improvepatientinclusivity.Oncology

researchanddevelopmenthasseen

anincreasingfocusontargeted

drugs,

with

innovativemechanismsofaction

fortreatmentofcancers

overthe

last

decade.

PD-1/PD-L1inhibitortrialstarts

grew54%

overthe

last

five

years,

with

most

ongoingPD-1/PD-L1late-stage

trialsinsinglecountriesandamajorityinChina,reflecting

thatthedrugs

beingtested

inthesetrialsmaynotbe

boundforinternationalmarkets.Antibody-drug

conjugatesareemergingwith

significantefficacy

acrossabroadrangeoftargets

with

15approvedgloballytodate.Sixbispecificantibodiesaremarketedgloballyforoncologywith

morethan130indevelopment.The

next-generation

biotherapeuticpipelinehasexpanded,

with

significantgrowth

inCART-celltherapyandmRNA

vaccineresearch.NOVEL

ACTIVE

SUBSTANCES

INONCOLOGYIn2022,21novelactive

substances

(NASs)

foroncologylaunchedglobally,down

from

the

record35in2021andbringingthe

averageannualnew

launchesfrom2018–2022to23.

Inthe

past

five

years,

115

NASs

havelaunchedgloballyandatotal

of237

since2003.

Whilenotallofthese

drugs

havebecomeavailableinevery2

|Global

Oncology

Trends2023:

Outlook

to2027country,most

haveaccesstosomekeybreakthroughsinimmuno-oncology

andthe

useofprecisionbiomarkershavebecomethestandard

ofcare

indozensoftumors.Despite

continued

discovery,development,

and

deliveryofnovel

treatments

for

cancerpatients,

the

global

oncologycommunity

and

patientsInthe

U.S.,134

uniquenew

cancermedicineshavelaunchedinthe

past

10

years,

with

manyapprovedformorethanoneindication.There

havebeen

importantconcentrationsofnew

therapiesinsolidtumors

ofthe

lung,breast,

andskin,aswellashematologicalmalignanciessuchasnon-Hodgkin

lymphoma

andmultiplemyeloma.Manyofthese

drugs

havereceivedorphandesignationsandareincreasinglyusingnovelmechanisms.

Emergingbiopharma

companiesoriginated70%

ofnewU.S.

oncologydrugs

in2022andlaunched71%

oftheirown

products.continue

to

struggle

withdisparities

in

access

and

care.isincreasing,theirlocation

andavailability

ofproductscan

potentiallyresultinlackofaccesstopatients

withoutthe

resourcestotravellongdistances.CANCERPATIENTACCESSAND

USE

OF

SCIENTIFICADVANCESSPENDING

ONONCOLOGYMEDICINESThe

numberoftreatedcancerpatients

globallygrewatanaverageof5%overthe

past

five

years

andisexpectedtoaccelerateinthenext

five

years

asaccesstonovelmedicinesfurther

expands.

Despite

thisgrowth,

thepaceofbringingnovelcancertherapiestopatients

isunevenacrosscountries,with

differencesinbiomarkertesting

rates,adoptionofnoveltherapies,andthepresenceofinfrastructure

capacity

todeliversomeofthe

most

advancedtherapies.Arangeofnoveloncologymedicineshavedemonstrated

significantclinicalvalueinthe

last

decade,

but

accessanduse

can

vary

greatlyacrosscountries.Cancer

medicine

spending

rose

to$196Bnglobally

in2022

and

is

expected

toreach

$375Bn

by

2027,

driven

bycontinued

innovation

and

offset

by

continued

uptake

ofbiosimilars

inmajor

markets.

Growth

inmajor

marketsis

driven

by

new

products

and

brand

volume

and

offsetby

losses

of

exclusivity,

including

biosimilar

impact.

TheU.S.

remains

the

largest

market

globally

followed

bymajor

countries

inEurope.China

oncology

spendinggrew

$6.8Bn

over

the

last

five

years,

driven

by

expandedaccess

tonew

therapies

and

brand

volume

and

offset

bylower

prices.

Globally,

seven

of

the

top

ten

tumors

haddouble-digit

spending

growth

over

the

last

five

yearsfrom

new

medicines

and

as

novel

therapies

move

toearlier

lines

of

therapy,including

PD-1/PD-L1inhibitors.The

robust

pipeline

of

next-generation

biotherapeutics

inoncology

includes

significant

potential

as

well

as

a

widerange

of

uncertainty

both

clinically

and

commercially,with

a

potential

tolift

the

current

$3Bn

global

spendingto$19Bnby

2027.

Ifusage

of

these

therapies

expandsincluding

novel

therapies

across

new

indications,Non-smallcelllungcancertreatmenthasshifted

toincludePD-1/PD-L1inhibitorsandkinaseinhibitorsasthestandard

ofcare

inthe

past

threeyears,

contributingtothe

extension

ofthe

mediandurationoffirst-linetherapybynearly

ayear.

Treatmentofwomen’s

cancers

andmultiplemyelomahasadvancedinrecentyears

asnovelmodalitiesbecomemorewidely

adoptedandimproveoutcomesforpatients.

Next-generation

biotherapeutics,includingcellandgenetherapies,continuetogrowincancer

treatment,

and

while

the

number

of

CAR

Tcentersmovement

of

existing

CAR

T-celltherapies

into

earlierlines

of

therapy,and

continued

improvement

of

safetyand

efficacy,

spending

could

reach

as

highas

$50Bn.

|

3Oncology

research

&

development

activities•

Oncology

trialstarts

remainedat

historically

highlevelsin2022,up22%

from

2018

andprimarilyfocusedonrarecancers

andsolidtumors.•

Antibody-drug

conjugatesareemergingwithsignificantefficacy

acrossabroadrangeoftargets,includingHER2,

CLDN18,andTrop-2,with

somesetbacks

assomeresearchisdiscontinued.•

Emergingbiopharmacompaniesareleadinginnovationinoncologyandwereresponsiblefor71%

ofthe

oncologypipelinein2022,upfrom

45%adecade

ago.•

Sixbispecificantibodiesaremarketedgloballyforoncologywith

manyindevelopmentforrarehematologicalcancers.•

China-headquartered

companiesareplayinganincreasingroleinthe

oncologypipelineaccountingfor23%

in2022,upfrom

only

5%adecade

ago.•

The

next-generation

biotherapeuticpipelineisfocused

oncelltherapies,particularly

CAR

Tinhematologicalcancers.•

Oncology

developmentisfocused

onsolidtumorswith

next-generation

biotherapeuticsandothernovelmodalities,suchasantibody-drug

conjugatesandbispecificantibodies,growingacrossallcancers.•

Nearly

250

trialstesting

CAR

T-celltherapiesinoncologystarted

in2022with

agrowingnumberacrossarangeofsolidtumors.•

Driven

bythe

successofCOVID-19vaccines,developmentofmRNA

vaccinesforcancerhasmorethandoubledsince2017,

with

focusonsolidtumors.•

PD-1/PD-L1inhibitortrialstarts

grew54%

overthelast

five

years,

with

81%

ofongoinglate-stage

trialsinsinglecountries.Trialstaking

placeonly

inChinarepresent1,287oftheover3,000

ongoinglate-state

PD-1/PD-L1trials,

reflecting

thatthedrugs

beingtested

inthese

trialsmaynotbe

boundforinternationalmarkets.•

Severalongoingandnew

trendsinoncologywillcontinue,includinguse

ofnovelmodalitiesinearlierlinesoftherapyandctDNA

use

inclinicalcareacrossthe

patient

journey.Oncology

clinical

activityrepresents

the

largest

portion

of

industryR&D

activitywith

significant

innovation

across

many

novel

modalities.4

|Global

Oncology

Trends2023:

Outlook

to2027ONCOLOGYRESEARCH&DEVELOPMENT

ACTIVITIESOncology

trial

startsremained

at

historically

high

levels

in

2022,up

22%

from

2018

and

primarily

focused

on

rare

cancersExhibit

1:

Clinicaltrialstartsbyyear,

2012–2022OncologyOncologynon-rareOncologyrare2,5002,0001,5001,0005002,5002,0001,5001,0005002,5002,0001,5001,000500002012201720222012201720222022HematologicalcancersSolidtumors2,5002,0001,5001,0005002,5002,0001,5001,00050000020122017202220122017202220122017PhaseIPhaseIIPhaseIIISource:

Citeline

Trialtrove,

IQVIA

Institute,

Jan

2023.•

Oncology

trialsrepresentasignificantportion

ofallclinicaltrialsandafter

reachinghistoric

levelsin2021,remainedflatin2022but

arestill

up29%

from

thenumberoftrialsstarted

in2017.•

Seventy-five

percentofoncologytrialsstarted

in2022aretesting

drugs

againstsolidtumors,

thoughgrowthwasflatin2022comparedto2021.•

Although

asmallshareoftrialsareaddressinghematologicalcancers,

the

numberoftrialsrose30%

from

2017

to2022,with

morethan550

trialsinvestigatingdrugs

fortreatmentofhematologicalcancers

started

in2022.•

PhaseII

trials,

includingPhaseI/II,

IIa

andIIb,representthe

largest

shareoftrials,

with

49%ofoncologytrialsstarted

in2022beingPhaseIIcomparedto41%

PhaseIand10%PhaseIII.•

Most

oncologytrialsarefocused

onrarecancers,

with56%

oftrialstarts

in2022evaluatingmedicinesforrarecancers,

howeverrareoncologytrialstarts

fell6%in2022after

a25%jumpin2021.Notes:

Phase

II

includes

phases

I/II,

II,

Iia,

IIb.

Phase

III

includes

phase

II/III

and

III.

Terminatedtrials

are

included

to

track

the

activity

involved

with

theirinitiation,

partial

execution

and

termination.

Trialswere

industry

sponsored,

interventional

trials

and

device

trials

were

excluded.

|

5ONCOLOGYRESEARCH&DEVELOPMENT

ACTIVITIESEmerging

biopharma

companies

were

responsible

for

71%

of

theoncology

pipeline

in

2022,

up

from

45%a

decade

agoExhibit

2:

Number

of

Phase

I

toregulatory

submission

oncology

pipeline

products

by

company

segment,

2013–20222,5002,2872,2022,1752,0001,5001,0005001,8521,5861,3501,1381,00820159088820201320142016EBP2017Large201820192020Small20212022MidSource:

IQVIA

Pipeline

Intelligence,

Dec

2022;

IQVIA

Institute,

Apr

2023.•

The

numberofproducts

underdevelopmentinoncologyhasgrownsignificantly

overthe

lastdecade,with

morethan2,000

products

currentlyunderdevelopment.•

Since2020,oncologypipelinegrowth

hasslowedgrowingjust

5%overthe

last

two

years,

with

15%growth

inthe

emergingbiopharmapipelinecomparedtoa13%

declineacrosslargercompanies.•

Emergingbiopharmacompanies—defined

asthosewith

less

than$500Mn

inannualsales

andR&Dspendingless

than$200Mn

peryear—areresponsiblefor71%

ofproducts

currently

underdevelopmentforcancers,

anincreasefrom

51%

in2017.•

Of

theemergingbiopharmacompaniesworking

inoncology,77%

aresolely

focused

ononcologydrugresearchanddevelopmentandofthosefocused

solelyononcology,72%

areonly

developingasingledrug.•

Large

pharmacompanies—those

with

greaterthan$10Bninannualsales

—haveseen

adecliningshareofthe

oncologypipeline,responsiblefor21%

ofproductscurrently

underdevelopment,down

from

36%in2017.Notes:

Analysis

includes

medicines

in

active

research

with

afocus

on

cancer

therapeutics

and

does

not

include

supportive

care.

Company

segment

when

twoor

more

companies

are

involved

is

determined

by

the

larger

sales

segment.

Emerging

biopharma

companies

(EBP)

are

those

with

either

R&D

spend

less

than$200Mn

or

global

sales

up

to

$500Mn

per

year.Small

companies

have

global

sales

between

$500

million

and

$5Bn

per

year.Mid-sized

companies

have

globalsales

between

$5Bn

and

$10Bnper

year.Large

companies

have

global

sales

exceeding

$10Bnper

year.6

|Global

Oncology

Trends2023:

Outlook

to2027ONCOLOGYRESEARCH&DEVELOPMENT

ACTIVITIESDrugs

from

China-headquartered

companies

have

risen

to23%ofthe

oncology

pipeline

from

only

5%

a

decade

agoExhibit

3:

NumberofoncologydrugsovertimeandcountryshareofpipelinePhaseItoregulatorysubmissionbasedoncompanyheadquarterslocation,2007–20223,0002,5002,0001,5001,00050050%45%40%35%30%25%20%15%10%5%47%46%45%42%27%12%26%26%10%23%21%11%3%5%5%2%9%2%3%20222%020070%2012U.S.20172022200720122017ChinaEuropeJapanSouthKoreaAllothersSource:

IQVIA

Pipeline

Intelligence,

Dec

2022;

IQVIA

Institute,

Apr

2023.•

Currently,morethan1,000companiesandnearly

50academicorresearchgroupsaroundtheworldareinvolvedinthe

oncologypipeline.•

Products

from

China-headquartered

companiesnowrepresent23%

oftheoncologypipeline,upfrom

10%five

years

agoand3%in2007

andpassingEuropeforthe

first

timein2022.

The

active

oncologypipelinefrom

China-headquartered

companieshasmorethantripled

inthe

last

five

years,

highlightingthe

importantrolethatcompaniesheadquartered

therewillplayinthe

developmentofnew

products

globally.•

The

U.S.

shareofthe

oncologypipelinehasfallen5%overthe

past

15

years

but

remainsabove40%.•

Europe’ssharedeclinedto21%

in2022,down

from26%five

years

ago,whiletheabsolutenumberofactive

oncologyprogramsgrewby19%

—from458to546.•

South

Korea’sshareoftheoncologypipelinehasremainedlowandrelatively

stable

despite82%growthinthe

absolutenumberofactive

programsoverthelast

five

years.•

Companiesheadquartered

inJapanhaveseen

adecliningshareofthe

oncologypipeline,droppingto5%in2022,down

from9%

five

years

ago,andan11%dropinabsolutenumberofactive

oncologyprogramssince2017.Notes:

Analysis

includes

medicines

in

active

research

with

afocus

on

cancer

therapeutics

and

does

not

include

supportive

care,

with

phase

determined

by

thehighest

phase

of

research

in

each

year

regardless

of

indication.

Each

company

involved

in

adrug’s

development

is

counted

individually,

so

productswith

more

than

one

company

involved

are

counted

more

than

once

and

may

be

included

in

more

than

one

region.

Europe

is

defined

as

any

country

incontinental

Europe.

|

7ONCOLOGYRESEARCH&DEVELOPMENT

ACTIVITIESOncology

development

is

focused

on

solid

tumors

withnext-generation

biotherapeutics

growing

across

all

cancersExhibit

4:

OncologyR&DpipelinePhaseItoregulatorysubmissionbytype,

2012–2022HematologicalcancersSolidtumorsNext-generationbiotherapeutics2,0001,8001,6001,4001,2001,000800Antibody-drugconjugatesBispecificantibodiesImmuno-oncologicsProteinkinaseinhibitors600Otherbiologics400Othertargetedsmallmolecules2000201220142016201820202022201220142016201820202022AllothersSource:

IQVIA

Pipeline

Intelligence,

Dec

2022;

IQVIA

Institute,

Jan

2023.•

Oncology

researchanddevelopmenthasseen

anincreasingfocusontargeted

drugs,

with

innovativemechanismsofaction

fortreatmentofcancers

overthe

last

decade.•

Bispecific

antibody

developmentforcancertreatmenthasgrownsignificantly,nowrepresenting7%

ofboththe

hematologicalcancerandsolidtumorpipelines,indicatinganincreasingfocusonthe

ability

ofthesemoleculestoact

onmultipletargets

orthroughdifferentmechanismsofaction.•

Whiledevelopmentofdrugs

forhematologicalcancersdeclined4%in2022,clinicaldevelopmentforsolidtumorcancers

grew5%followingaslightcontractioninthe

pipelinein2021.•

Antibody-drug

conjugates,whichallowfortargetingcytotoxic

agents

directly

tocancercellsreducingthe

non-specificity

ofolderchemotherapeutics,areprimarilyfocused

onsolidtumors,

with

65%growthoverthe

last

five

years

insolidtumordevelopment.•

Immuno-oncologics,

includingPD-1/PD-L1checkpointinhibitors,whichsaw

significantgrowth

overthe

lastdecade,havebeguntotaper

off

inrecentyears,

withdeclinesbeginningin2018,indicatingacrowdedmarketandswitch

toevennewertargeted

molecules.•

Next-generation

biotherapeutics

are

increasinglyunder

investigation

for

hematological

cancers,

with

thenumber

of

products

currently

inactive

research

morethan

four

times

what

it

was

in2017

and

accounting

for28%

of

the

hematological

cancer

pipeline.Notes:

Analysis

includes

medicines

in

active

research

with

afocus

on

cancer

therapeutics

and

does

not

include

supportive

care,

with

phase

determined

bythe

highest

phase

of

research

in

each

year

regardless

of

indication.

Other

includes

non-targeted

mechanisms

within

categories

of

cytotoxics,

hormonal,

andradiotherapeutics.

Products

being

investigated

for

more

than

one

type

of

cancer

may

be

included

in

both

hematological

and

solid

tumor

cancers.8

|Global

Oncology

Trends2023:

Outlook

to2027ONCOLOGYRESEARCH&DEVELOPMENT

ACTIVITIESPD

-1/PD

-L1

inhibitor

trial

starts

grew

54%

over

the

last

5

yearswith

81%

of

ongoing

late-stagetrials

in

single

countriesExhibit5:PD-1/PD-L1inhibitortrialstartsbyphaseandongoingtrialsbygeographyPD-1/PD-L1inhibitortrialstartsbyphaseOngoinglate-stagePD-1/PD-L1inhibitortrialsbygeography,2022n=3,3681,6001,4001,2001,000800Multinational19%Singlecountry81%Top10countrieswithsinglecountrylate-stagetrials1,6001,20080040001,28760084440082646444393938200330201320162019PhaseII2022PhaseIPhaseIIISource:

Citeline

Trialtrove,

IQVIA

Institute,

Apr

2023.•

The

FDAapprovedthefirst

PD-1/PD-L1checkpointinhibitor,pembrolizumab(Keytruda),

forpatients

withmelanomain2014,andsincethensixadditionalPD-1/PD-L1inhibitorshavebeen

approvedacrossarangeofhematologicalcancers

andsolidtumors.•

Chinahas1,287ongoinglate-state

PD-1/PD-L1trialsthatareonly

beingconducted

domestically

andreflectthatthe

drugs

beingtested

inthese

trialsmaynotbeboundforinternationalmarkets.•

Morethan80%

ofclinicaltrialswith

PD-1/PD-L1inhibitorsareinvestigatingtheiruse

incombinationwith

otherdrugs,

with

PD-1/PD-L1inhibitorsbeingtested

incombinationwith

therapiestargeting

nearly•

In2022,1,236trialsstarted

globallytesting

PD-1/PD-L1inhibitors,down

11%

from

2021but

up54%

from

the804

started

in2017.300

differenttargets

andpathways.1•

Of

themorethan3,000

late-stage

PD-1/PD-L1trialsthatwereongoingin2022,81%

werebeingconductedinasinglecountry.Notes:

Phase

II

includes

Phases

I/II,

II,

IIa,

IIb.

Phase

III

includes

Phase

II/III

and

III.

Terminatedtrials

are

included

to

track

the

activity

still

involved

with

theirinitiation,

partial

execution

and

termination.

Trialswere

industry

and

non-industry

sponsored,

interventional

trials

and

device

trials

were

excluded.

Ongoingtrials

in

2022

are

those

that

are

recruiting

patients

or

those

where

patient

recruitment

has

completed

but

final

dosing,

follow-up,

data

collection