A new analysis from data-driven solutions major Phesi of 65,061 actively recruiting clinical trials across 186 countries reveals that 4,361 studies—6.7% of the global total—are being disrupted by turmoil in the Middle East. Among 356,699 recruiting investigator sites worldwide, 7,958 (2.2%) are in the affected region, with Phase III trials bearing the brunt at 2,732 impacted sites.

 

Turkey, Israel, and Egypt account for the highest concentration of affected sites. Oncology trials are among the hardest hit, with non-small cell lung cancer taking the lead, followed by breast cancer. Other conditions disrupted include heart failure, multiple myeloma, and Crohn’s disease.

 

“Clinical development has become deeply interconnected. When disruption occurs the impact extends beyond individual sites, particularly in high-priority disease areas such as oncology,” said Dr. Gen Li, founder and CEO of Phesi. 

 

“The impact on Phase III trials is particularly significant, as these later-stage studies involve larger, committed patient populations and represent years of investment. Patient safety and the safety of investigators and clinical staff must remain the primary consideration, alongside the need to keep existing trials going.”

 

The analysis highlights that major pharmaceutical companies have substantial exposure in the region. All top 10 global pharma firms maintain large numbers of investigator sites in affected countries, with some operating between 400 and 500 sites. Such a footprint means that regional disruption can ripple across global trial timelines, emphasizing the need for continuity amid volatile conditions.

 

“Disruption and uncertainty are becoming a structural feature of clinical development. The priority is not only to respond, but to proactively use data to understand exposure and mitigate risk,” Dr. Li added. 

 

“Such periods of disruption reinforce the need for a precise, data-driven approach to development. Sponsors need to quickly understand their exposure, identify alternatives and adapt trial strategies in real time, while maintaining high standards of patient safety and data integrity. There is also an opportunity to explore approaches such as external control arms and modeling techniques, including digital twins, particularly in well-characterized disease areas.”