Neuroscience and oncology fuel high hopes for therapeutic R&D progress among 90-plus surveyed biopharma industry leaders.

From synthetic data to real-world data, from patient engagement to patient stratification, from combination trials to master protocols and from fully decentralized through hybrid to onsite trials, the world of clinical development is undergoing major changes. Fifty executives share their predictions around clinical trial trends for the year ahead.

Deal-making between big pharma and biotech looks set to rise with a looming patent cliff increasing the need for the former to replenish its pipelines. Meanwhile, biotechs need partners to help them advance amid the ongoing big freeze on raising cash on public markets.

With valuations down and borrowing costs up, many industry insiders are expecting Darwinian scenes in biotech this year. Survival of the fittest is the order of the day: companies with riskier, less commercially defined propositions will struggle, while platform companies with multiple shots on strong goals will increasingly find favor in a more risk-averse environment.