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This article shows that early phase clinical trials in oncology involve a process of localized innovation that sets them apart from the diffusion model used in the sociology of innovation. For the last ten years, physician-researchers have been setting up specialized units, increasing the number of early phase clinical trials and their visibility among patients. These trials are seen as a potential form of treatment for patients who have not responded to other therapies. A study of physicians, political leaders, and patients in France, conducted over a nine-year period, shows that the development of this research activity relies on conducting clinical trials in collaboration with the pharmaceutical industry as well as promoting the clinical value of these trials. This integration of biomedical research into care leads to major disparities at the scale of the French health care system as a whole, raising the issue of social inequality in access to innovations.