Practical Guide to Clinical Trial Accessibility: Making Trial Participation a Standard of Care

Abstract

Despite being a cornerstone of cancer treatment advancement, clinical trials remain inaccessible for many patients because of structural, socioeconomic, and systemic barriers. In this multidisciplinary perspective piece, stakeholders from patient advocacy, community oncology, industry, and academic medicine offer a collaborative overview of key challenges and practical solutions to improve trial accessibility. Patient advocates highlight the need to address language barriers, financial toxicity, and underrepresentation through community engagement and patient-centered trial design. Community oncologists underscore infrastructure limitations, generalist practice burdens, and misaligned trial offerings, calling for eligibility reform and cooperative trial models. Industry partners examine how overly restrictive criteria and inconsistent protocol practices hinder diversity and propose portfolio-wide strategies, such as protocol watch lists, for inclusive design. Academic oncologists focus on trial complexity, investigator burden, and limited generalizability, advocating for pragmatic and decentralized trial paradigms. Together, these perspectives underscore the shared responsibility across sectors to modernize clinical trial design, reduce access barriers, and ensure that trial participation becomes a standard and equitable component of cancer care.