On Jan 31, 2020, the UK formally ended it’s 47-year membership of the EU. As a part of this, the Medicines and Healthcare products Regulatory Agency (MHRA) withdrew from the European Medicines Agency (EMA). Over the past 3 years, and as the UK’s standalone regulator, the MHRA has implemented many changes, but announcements on Jan 24 and March 21, 2023, herald the largest shake-up of trial regulation in 20 years. With the MHRA solely at the helm of marketing authorisation of new medicines, how has Brexit affected access to the latest cancer treatments for patients in the UK?