Across 285 antibody-drug conjugate (ADC) Phase II/III trials, the strongest site signal is Spanish: Hospital Universitari Vall d’Hebron appears in 119 trials, equal to 41.8% of the dataset. Spain also leads country-level activity with 8,773 planned participant allocations (20.8%) and 1,786 planned site allocations (21.3%).
The top 10 named sites account for 757 of 8,285 named site-trial appearances (9.1%). Five of the top 10 are in Spain, three are in Italy, and two are in France.
ADC trial access is concentrated in high-volume comprehensive oncology centers. Vall d’Hebron, Gustave Roussy, Catalan Oncology Institute, Hospital Clínic de Barcelona, and 12 de Octubre form the clearest Iberian/French hub pattern.
Spain, France, Germany, and Italy together account for 30,172 of 42,231 planned participant allocations (71.4%) and 5,827 of 8,375 planned site allocations (69.6%).
The leading ADC geography is not evenly distributed. Spain leads both site and participant allocations, while France and Germany are nearly tied on planned participants despite France having fewer planned site allocations than Spain.
Breast cancer is the largest ADC site-demand category, with 2,236 of 8,375 planned site allocations (26.7%) and 16,042 of 42,231 planned participant allocations (38.0%). Breast, lung, hematologic, and gynecologic indications together represent 77.4% of all planned site allocations.
ADC development is still dominated by oncology scale indications. Breast and lung cancer alone account for 48.9% of planned site allocations, while hematologic and gynecologic indications add a second major operating layer.
Across the six largest disease families and six largest countries, Spain has the highest site allocation in breast cancer (495), lung cancer (450), and urothelial/bladder cancer (177). Germany leads hematologic malignancy allocations (246), while Italy leads gastrointestinal cancer allocations (178).
| Spain | France | Germany | Italy | Poland | Belgium | |
|---|---|---|---|---|---|---|
| Breast cancer | 495 | 403 | 485 | 283 | 108 | 112 |
| Lung cancer | 450 | 276 | 244 | 277 | 149 | 83 |
| Hematologic malignancy | 197 | 212 | 246 | 190 | 88 | 38 |
| Gynecologic cancer | 187 | 193 | 139 | 165 | 81 | 82 |
| Gastrointestinal cancer | 150 | 126 | 124 | 178 | 40 | 45 |
| Urothelial / bladder cancer | 177 | 130 | 98 | 102 | 28 | 24 |
The country mix changes by indication. Spain is the broadest ADC hub across solid tumors, Germany is comparatively strong in hematologic malignancies, and Italy over-indexes in gastrointestinal cancer site allocation.
Phase III ADC trials account for 4,995 of 8,375 planned site allocations (59.6%) and 24,155 of 42,231 planned participant allocations (57.2%). By authorization year, 2024 contributes 4,258 planned site allocations (50.8%).
Although the cohort includes more Phase II than Phase III trials, the operational load is later-stage: Phase III contributes nearly six in ten planned site allocations and planned participant allocations.
ADC means antibody-drug conjugate.
Site allocation means a planned trial site counted at the country level in the trial geography record.
Site appearance means one named site appearing in one ADC trial. A site appearing in multiple trials is counted once per trial for ranking purposes.