Finding eligible patients for oncology clinical trials—and identifying appropriate trials for patients, particularly in community settings where most care is delivered—remains one of the most persistent challenges in cancer research and care delivery. For multidisciplinary cancer care teams, trial identification often depends on fragmented systems, manual processes, and limited visibility across institutions, making timely, accurate trial matching difficult in routine care.
For patients with cancer who live in rural communities, participating in a clinical trial can require hours of travel, time away from work and family, and significant logistical coordination. As decentralized clinical trials (DCTs) become more common across oncology research, health systems are exploring how to bring more trial-related activities closer to home while maintainingthe rigor and oversight required for clinical research.
Despite continued expansion of oncology clinical trials across tumor types and treatment settings, meaningful patient enrollment continues to lag behind availability, highlighting a critical disconnect between trial activity and real-world access at the point of care. Providers understand the value of clinical trials. The greater challenge is communicating the role of clinical trials in a way that is meaningful, relevant, and accessible to patients.
Between 2015 and 2021, the FDA approved 82 new cancer therapies, the vast majority of which were studied in clinical trials that failed to adequately represent Black and Hispanic patients. Efforts to improve recruitment of underrepresented populations span a wide range of strategies, but few interventions have helped sites examine their own data and processes regarding trial recruitment. ASCO’s Research Site Self-Assessment for Enrollment in Clinical Trials, developed in partnership with ACCC, is a tool that helps sites identify potential opportunities for improving trial enrollment within their systems.
American Indian and Alaskan Native (AI/AN) populations are underrepresented in clinical trials due to a complex set of historic and present-day barriers. Past abuses by medical systems have eroded trust, research infrastructure often fails to reach communities in rural areas, and trials are designed without these groups in mind, making outreach for participation feel like an afterthought. The American Indian Cancer Foundation (AICAF), a nonprofit organization that bridges gaps in cancer care for AI/AN people, is tackling these disparities through education and awareness. This Native-led organization has used its deep cultural knowledge, along with input from its community, to design resources that address some of the biggest driving forces behind low participation of AI/AN patients in clinical trials.
Finding eligible patients for oncology clinical trials—and identifying appropriate trials for patients, particularly in community settings where most care is delivered—remains one of the most persistent challenges in cancer research and care delivery. For multidisciplinary cancer care teams, trial identification often depends on fragmented systems, manual processes, and limited visibility across institutions, making timely, accurate trial matching difficult in routine care.
In a time when drug discovery and therapeutic innovation in oncology are moving at an unprecedented pace, it is essential that the delivery of clinical trials adjusts accordingly to meet this demand and ensure participation is accessible to as many patients as possible. Sarah Cannon Research Institute (SCRI), a community-based oncology research program, is striving to do just that through its proprietary operations model, Accelero.
ASCENT‑05 (NCT05633654) is a phase 3, randomized, open‑label study evaluating whether adjuvant treatment of sacituzumab govitecanin combination with immunotherapy can improve outcomes in patients with early‑stage triple‑negative breast cancer (TNBC) who have residual invasive disease after neoadjuvant therapy and surgery. Patients enrolled in this study are randomly assigned to receive either sacituzumab govitecan plus pembrolizumab or physician’s choice of pembrolizumab alone or pembrolizumab in combination with capecitabine.