Early phase trials, including phase II trials, play a direct role in the UK’s ambitions to lead in life sciences innovation, as outlined in its commitment to fast and efficient clinical research environments (Life Sciences Vision, UK Government, 2021). The analysis by Manfrin and colleagues of clinical trial submissions (Manfrin et al., 2025), clearly highlights the domination of commercial sponsors when it comes to early phase ATMPs (92.8% of submissions). Why is this? It is clear that commercial sponsors have and continue to be positioned as central stakeholders (Lord O’shaughnessy, 2025), (the data supports this, commercial sponsors represented 85.1% of the total submissions) and in turn justifies their significant integration into the UK government and regulatory infrastructures that shape the clinical trial landscape. Non-commercial sponsors are now firmly placed on the periphery, yet despite this they demonstrate remarkable resilience by submitting the greater number of phase II trials (37.3 v 26.6%). Their ability to conduct complex trials in these conditions is a remarkable achievement, underscoring both the importance and the potential of non-commercial research. Ultimately, a more inclusive and equitable regulatory system is needed—one that recognises and supports the efforts of non-commercial sponsors, enabling them to continue their vital contributions to the UK’s clinical research ecosystem, rather than keeping them on the outside. Mohammed Zubair, Ph. D Sponsor Representative The University of Manchester