Why people with lung cancer in Europe are being left behind on clinical trials

Lung cancer is the leading cancer killer in Europe. So you might expect Europe to be at the forefront of clinical trial research into the disease. The reality is very different.

Less than 2% of global clinical trials focus on lung cancer. And of the lung cancer trials that do exist, 70% take place in China, the United States and Japan. Europe, the region with the worst lung cancer outcomes in the world, is largely absent from the picture.

This has real consequences for people living with lung cancer right now.

What is a clinical trial?

A clinical trial is a research study that tests whether a new treatment works and is safe. Before any new medicine can be approved and made available, it has to go through this process.

For people with lung cancer, trials matter for a very specific reason. If you take part in one, you could get access to a new treatment up to ten years before it reaches the wider market. For someone facing a serious diagnosis, that window can be everything.

Europe is falling behind

Global clinical trials have grown by 38% over the past decade. That sounds like good news. But Europe's share of those trials has halved over the same period. The result is 60,000 fewer trial places for people living in Europe.

That decline is happening across the board. The number of oncology trials in Europe is now lower than it was in 2018.

It is not equal within Europe either

Even within Europe, access to trials varies enormously depending on where you live. Germany leads in the number of trials conducted, followed by the UK and France. But in countries like Bulgaria and Ireland, the numbers are far lower.

The inequality is sharpest in Eastern Europe. Lung cancer rates there are among the highest on the continent, yet the number of available trials is comparatively small. And it is rare for people to be able to access a trial outside their own country, even within the EU.

Why is this happening?

Several factors are driving Europe's decline as a destination for clinical trials.

Regulatory fragmentation makes it complicated and expensive to run trials across multiple European countries. Companies that fund trials increasingly choose to base them in the US or China, where the process is simpler and populations are larger.

Non-commercial research, which is not driven by profit, also makes up a smaller share of trials in Europe than globally, around 50% compared to 70% worldwide. That matters because non-commercial trials are more likely to focus on areas of high unmet need rather than commercial opportunity.

There is also an awareness problem. Many people who could benefit from a trial simply do not know that trials exist or that they might be eligible.

What needs to change

Lung Cancer Europe is calling for urgent action on four fronts.

Governments across Europe need to increase investment in independently funded trials, so that research priorities are driven by patient need rather than commercial interest alone.

Rules for running trials across multiple European countries need to be simplified. Too much red tape is pushing research elsewhere.

People with lung cancer need to be involved in shaping research from the start, contributing to questions, design and what outcomes actually matter.

And barriers to accessing trials across borders within Europe need to be understood and removed, so that where you live stops determining what you can access.

Read the full briefing

Lung Cancer Europe has published a policy brief setting out the evidence on clinical trials access in Europe and what policymakers need to do about it.