Clinical trials remain out of reach for many Americans, with only 7% of patients with cancer participating in clinical trials, according to a new report from the American Society of Clinical Oncology’s (ASCO) State of Cancer Care in America series.
Experts agree that access to trials is a key element in driving progress in cancer care and improving patient outcomes. The study, published in JCO Oncology Practice, highlights long-standing barriers to trial participation and highlights efforts to bridge the accessibility gap.
“Clinical trial participation contributes to advances in high-quality care, informs clinical practice guidelines, and improves health outcomes,” said Julie R. Gralow, MD, FACP, FASCO, ASCO’s Chief Medical Officer and Executive Vice President. “Continued access to clinical trials is vital to ensuring that progress is made to identify optimal treatment options for patients everywhere, as the number of patients with cancer as well as survivors is projected to increase.”
Julie R. Gralow, MD, FACP, FASCO
David D. Chism, MD, MS
People who participate in cancer clinical trials tend to be younger; healthier; and less racially, ethnically, and geographically diverse than the population receiving cancer care in the United States, according to the report.
“The current landscape of cancer clinical trials in America does not accurately reflect the reality of those affected by the disease,” said David D. Chism, MD, MS, report coauthor and Chair of ASCO’s Health Services Research (HSR) Committee. “This skewed representation is a critical issue, because it can produce findings that fail to apply to all patients and may not be reflective of treatment outcomes or side effects specific to certain understudied groups, ultimately hindering progress toward developing effective cancer therapies.”
The report highlights a variety of challenges that prevent patients from accessing clinical trials. Most trials are conducted at academic medical centers or large oncology practices, making access difficult for those who don’t live nearby. Additionally, trial design characteristics, such as overly restrictive eligibility criteria in protocols, may unnecessarily exclude patients based on age, comorbidities, or other factors. Financial burdens, time concerns, and inadequate caregiving support may also discourage patients from participating in clinical trials.
© American Society of Clinical Oncology. ASCO in Action. October 6, 2025. All rights reserved.
