Variability in Clinical Trial Enrollment for Patients with Advanced Cancer at the Physician and Practice Levels
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By
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Changchuan Jiang
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Chuan Angel Lu
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Joshua M. Liao
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Ryan D. Nipp
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K. Robin Yabroff
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Helen H. Moon
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Song Zhang
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Xin Hu
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Tian Zhang
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October 6, 2026
Clinical Scorecard: Variability in Clinical Trial Enrollment for Patients with Advanced Cancer at the Physician and Practice Levels
At a Glance
| Category | Detail |
|---|
| Condition | Advanced Cancer |
| Key Mechanisms | Clinical trial participation is influenced by physician referral practices and practice infrastructure. |
| Target Population | Adults aged 18 years or older with advanced or metastatic solid malignancies. |
| Care Setting | Oncology practices with varying trial availability and infrastructure. |
Key Highlights
- Enrollment in clinical trials for advanced cancer remains below 10%.
- Physicians and practices are essential gatekeepers for trial participation.
- Variation in trial engagement exists due to differing organizational priorities.
- A national cohort study analyzed over 200,000 patients with advanced cancer.
- Data derived from the US Flatiron Health Research Database.
Guideline-Based Recommendations
Diagnosis
- Patients must have a diagnosis of advanced or metastatic solid malignancies.
Management
- Physicians should initiate discussions about clinical trial participation.
Monitoring & Follow-up
- Track clinical trial participation rates and associated delivery system factors.
Risks
- Potential disparities in trial access based on race and ethnicity.
Patient & Prescribing Data
Adults with advanced or metastatic cancer treated from January 1, 2011, through December 31, 2024.
Clinical trial participation operationalized as receipt of a clinical study drug.
Clinical Best Practices
- Ensure adequate infrastructure for clinical trial options in oncology practices.
- Identify and support 'super enrollers' to enhance trial participation.
- Address systemic barriers to improve equitable access to clinical trials.
Related Resources & Content
