# Contract research organisations (CROs)

Source: https://onco.cc/technologies/contract-research-organisations/  
OnCo record `contract-research-organisations` (Technology). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Companies that run clinical trials for sponsors: sites, monitoring, data, and regulatory filing.

## Summary

IQVIA, ICON (including PRA), Parexel, Fortrea (ex-Labcorp), Syneos, Medpace, PPD (Thermo Fisher), and Charles River (preclinical) execute the majority of industry oncology trials. Oncology is the largest CRO therapeutic segment; capabilities in biomarker-driven enrolment, imaging core labs (e.g. ICON Medical Imaging, Calyx), and China/Asia site networks differentiate. Consolidation and AI-driven site selection are current trends.

## Fields

- Kind: Technology
- Status: standard-of-care
- Last checked: 2026-09-08
- Tags: supporting
- Principle: Outsourced trial operations under sponsor oversight: feasibility, site management, monitoring, pharmacovigilance, biostatistics, and submission.
- Strengths: Global reach and scale; Specialised oncology expertise
- Limitations: Cost; Sponsor oversight burden; Enrolment delays remain the norm

## Sources

- FDA guidance: ICH E6(R3) good clinical practice: https://www.fda.gov/regulatory-information/search-fda-guidance-documents/e6r3-good-clinical-practice-gcp

## Connected records

- fronts: [AI & Computation](https://onco.cc/fronts/ai-computation/)
- technologies: [Clinical trial software (EDC, eCOA, CTMS, RTSM)](https://onco.cc/technologies/clinical-trial-software/), [Imaging core labs and central review](https://onco.cc/technologies/imaging-core-labs/)
- companies: [Charles River Laboratories](https://onco.cc/companies/charles-river/), [Fortrea](https://onco.cc/companies/fortrea/), [ICON plc](https://onco.cc/companies/icon-plc/), [IQVIA](https://onco.cc/companies/iqvia/), [Medpace](https://onco.cc/companies/medpace/), [Parexel](https://onco.cc/companies/parexel/), [Sarah Cannon Research Institute](https://onco.cc/companies/sarah-cannon-research-institute/), [Thermo Fisher Scientific](https://onco.cc/companies/thermo-fisher/)

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