European site-network evidence
European site activity is concentrated enough that the same institutions repeatedly appear across different trial types, but not concentrated enough for a short list of famous centres to explain the market. The strongest networks combine repeat high-performing institutions with a much broader long tail of sites.
Assistance Publique–Hôpitaux de Paris led the RNA Phase I–II cohort with participation in 9 of 31 trials and the Phase III infectious-disease cohort with 43 trial participations. Vall d’Hebron appeared in 8 of 31 RNA trials and tied for the lead in glioblastoma/glioma with 13 trial participations. These repeated appearances make large academic systems useful anchor candidates, but not a complete site strategy.
The top ten listed sites accounted for 16.1% of identifiable site-trial participations in glioma and 11.1% in Phase III infectious disease. In RNA Phase I–II, the leading site appeared in 29.0% of trials, but the cohort still involved 281 distinct European sites. Site selection therefore needs both repeat performers and deliberate long-tail coverage.
France was the largest platform in the infectious-disease Phase III cohort with 950 site entries and in glioma with 190 site placements. Poland led IBD with 611 site slots, while Spain had the largest RNA Phase I–II site footprint with 100 of 442 site slots. A generic ‘best countries for trials’ ranking therefore hides the indication-specific network.
In RNA Phase I–II, Spain had the largest site footprint with 100 of 442 site slots, while France had the largest planned participant allocation with 427 of 2,601 participants. Site density and expected recruitment contribution should therefore be evaluated as separate variables rather than using site count as a recruitment proxy.
IBD showed a broad multi-country network led by Poland and repeat commercial/academic centres, while glioma concentrated more visibly around specialist academic hospitals such as Heidelberg and Vall d’Hebron. RNA Phase I–II still reached 281 distinct sites despite being an advanced-modality cohort. The practical choice is not ‘centralised versus broad’ in the abstract; it depends on the patient pathway, specialist capability and recruitment burden of the programme.
The most consistent CTIS evidence across these cohorts is the recurring site or institution, country footprint and planned participant allocation. Investigator-level records can be useful, but they need person-level normalization and role consistency before they should be compared as a public ranking. For operational planning, institution recurrence is the more robust first screen.
Scope note. This page synthesizes findings from separate Trial Agents analyses of European CTIS cohorts. Each statistic remains tied to the phase, disease, modality and time window of its underlying analysis. Cross-cohort patterns are used as planning signals, not pooled estimates or causal claims.
79 trials: Heidelberg and Vall d’Hebron lead with 13 each; France has 190 sites and 2,408 planned patients.
Read the underlying analysis →Medical Network leads 100 IBD trials with 37 participations; Poland has 611 sites and 3,254 patients. mAbs dominate 43 trials.
Read the underlying analysis →31 early RNA trials use 442 site slots; AP-HP leads with 9 trials, Spain has 100 site slots and oncology drives 62.2%.
Read the underlying analysis →France leads EU sites (950) and patients (18,214); AP-HP tops sites (43 trials); small molecules dominate 92/142 trials.
Read the underlying analysis →Vall d’Hebron leads 91 phase 2 and 3 trials with 28; Germany has 2,159 allocated patients and small molecules appear in 63 trials.
Read report →Gustave Roussy leads 78 HNSCC trials with 30 participations; France leads countries with 379 sites and 3,542 patients.
Read report →Hospital Sant Joan de Déu led 488 paediatric Phase 3 trials with 114 trial participations; Spain had 1,692 site slots.
Read report →AP-HP leads 51 trial participations; France has 1,029 sites/11,010 patients; small molecules appear in 102/164 trials; CROs in 96/164.
Read report →Hospital Universitario La Paz leads with 6 trials; Spain has 100 sites and Poland has 4,741 planned participants.
Read report →AP-HP leads with 174 site participations; France has 1,193 sites, Poland 7,039 patients, and CROs appear in 164/257 trials.
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