Across 97 European CTIS pancreatic cancer Phase II/III trials, 37 trials listed CRO or outsourced provider support, equal to 38.1% of the cohort. CRO-supported trials represented 680 of 1,318 planned sites, or 51.6% of site capacity, showing that outsourcing is concentrated in operationally heavier trials rather than merely in trial count. IQVIA was the most active named provider, supporting 9 of 37 CRO-supported trials, followed by Parexel and ICON with 8 trials each.
Among 37 CRO-supported trials, IQVIA appeared in 9 trials, or 24.3% of CRO-supported studies. Parexel and ICON each appeared in 8 trials, or 21.6%, while Medidata Solutions appeared in 6 trials, or 16.2%.
The active-provider landscape is split between full-service CROs and operational technology or specialist vendors. This matters for CTIS and EU trial planning because outsourced responsibility is not only trial management; it also includes data capture, central labs, imaging, randomization, safety, and submission-adjacent execution.
CRO use increased strongly with CTIS country complexity. Only 9 of 54 single-country trials used CRO support, or 16.7%, compared with 7 of 8 trials across 6 or more countries, or 87.5%. Site scale showed the same pattern: 7 of 12 trials with 31 or more sites used CRO support, or 58.3%.
The clearest outsourcing trigger is EU geography, not raw participant count. CRO-supported trials averaged 3.9 countries and 18.4 sites, compared with 1.5 countries and 10.6 sites for non-CRO trials, making CTIS multi-country coordination the strongest operational demand signal.
Basket or multi-tumor studies that included a pancreatic cancer cohort had the highest CRO use: 23 of 44 such trials used CRO support, or 52.3%. Pancreatic-only trials used CRO support in 14 of 53 cases, or 26.4%.
| Indication scope | CRO trials | Rate |
|---|---|---|
| Basket / multi-tumor with pancreatic cohort | 23 / 44 | 52.3% |
| Resectable / borderline / adjuvant PDAC | 4 / 13 | 30.8% |
| Advanced / metastatic pancreatic cancer | 8 / 31 | 25.8% |
| Pancreatic cancer not further specified | 2 / 9 | 22.2% |
CRO demand is strongest when pancreatic cancer is part of a broader solid-tumor or multi-indication development program. These studies usually require more vendor coordination, cross-country CTIS alignment, multiple eligibility pathways, and more complex biomarker or imaging operations.
CRO-supported pancreatic trials were most concentrated in Spain, France, Italy, Germany, and Belgium by planned site load. Spain accounted for 186 CRO-supported sites, France for 140, Italy for 99, Germany for 80, and Belgium for 42.
Spain and France are the main CRO-supported CTIS execution markets in this pancreatic cancer cohort. Sponsors planning EU submissions in pancreatic cancer should expect CRO value to be highest where country activation, site contracting, oncology-network coverage, and CTIS Part II coordination converge.
The most frequently outsourced functions were central imaging, dosimetry, or radiology services in 30 of 97 trials, or 30.9%; central laboratory, biomarker, or sample-handling services in 28 trials, or 28.9%; and data capture, EDC, eCRF, CTMS, or eTMF services in 24 trials, or 24.7%.
Pancreatic cancer outsourcing is heavily specialist-driven. Imaging, dosimetry, biomarker, sample, EDC, and CTIS submission-adjacent services are more prominent than pure recruitment support, reflecting endpoint complexity, radiopharmaceutical activity, biomarker stratification, and EU operational coordination.
ADC trials had the highest CRO use among major modality groups: 7 of 8 ADC trials used CRO support, or 87.5%. Monoclonal antibody trials used CRO support in 12 of 21 trials, or 57.1%, while radiopharmaceutical trials used CRO support in 5 of 9 trials, or 55.6%.
ADC, monoclonal antibody, and radiopharmaceutical studies are more CRO-intensive than small-molecule pancreatic trials. The operational reason is likely the need for imaging, central laboratory, biomarker, sample, and safety infrastructure across multiple EU countries.
Pharmaceutical company sponsors used CRO support in 34 of 49 trials, or 69.4%. Hospital or clinic sponsors used CRO support in 1 of 33 trials, or 3.0%, while educational institution sponsors used CRO support in 1 of 4 trials, or 25.0%.
| Sponsor type | CRO trials | Rate |
|---|---|---|
| Pharmaceutical company | 34 / 49 | 69.4% |
| Educational institution | 1 / 4 | 25.0% |
| Laboratory / research / testing facility | 1 / 5 | 20.0% |
| Hospital / clinic / healthcare facility | 1 / 33 | 3.0% |
Commercial sponsors are the clearest buyer segment for CRO support in pancreatic cancer CTIS submissions. Investigator-led hospital and academic trials appear more likely to run with internal infrastructure or narrower third-party support, even when their site and participant footprints are large.
CRO-supported trials generated 129 country-level CTIS processing-time records, compared with 87 records in non-CRO trials. Median country processing time was 211 days in CRO-supported records versus 304 days in non-CRO records.
CRO-supported trials carry more CTIS country-level execution volume and more sites per trial. This supports a practical market view: CRO need in pancreatic cancer is highest when the sponsor must coordinate several EU/EEA Part II packages, site networks, vendors, and country-level authorizations at the same time.
The same CTIS dataset answers several adjacent targeting questions: which provider names recur, which countries create the largest site load, which modalities trigger specialist outsourcing, and which sponsor types are most likely to buy CRO support.
For pancreatic cancer Phase II/III trials in Europe, the strongest CRO opportunity is not generic pancreatic cancer. It is multi-country, commercially sponsored, vendor-heavy oncology development, especially where CTIS submissions span several countries and require imaging, central labs, EDC, biomarker, safety, and regulatory execution.