At least a third of pivotal-trial sites in community and rural settings
Most cancer patients are treated outside big academic hospitals, but most trials are run inside them. Requiring a share of sites to be community practices would bring trials to where patients are.
Regulators and public funders would expect registrational trials to open at least 30 percent of sites in community oncology practices and non-metropolitan hospitals, supported by hub-and-spoke oversight from an academic centre (the NCORP model). Sponsors report site mix in the application and diversity plan.
- Trials enrol too few, too slowly · Fewer than one in ten adults with cancer joins a trial. Trials close for lack of patients, not lack of ideas.
- Trials do not represent the people who get cancer · Older, Black, Hispanic, Asian, rural, poor and multimorbid patients are under-represented, so results may not apply to them.
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not linked directly; found by shared links- IdeaCommunity health workers and trusted local organisations paid to recruit for trials
Shares Trials do not represent the people who get cancer, Trials enrol too few, too slowly, National Cancer Institute (NIH).
- IdeaRemove blanket exclusions for mental illness and dementia; support consent instead
Shares Trials do not represent the people who get cancer, Trials enrol too few, too slowly, National Cancer Institute (NIH).
- IdeaMobile research units bring trial visits to rural towns
Shares Trials do not represent the people who get cancer, Trials enrol too few, too slowly, National Cancer Institute (NIH).
- IdeaLay trial navigators funded per centre, evaluated in a randomised trial
Shares Trials do not represent the people who get cancer, Trials enrol too few, too slowly, National Cancer Institute (NIH).
- IdeaStop excluding people with a prior cancer, controlled HIV, or treated hepatitis
Shares Trials do not represent the people who get cancer, Trials enrol too few, too slowly, National Cancer Institute (NIH).
- IdeaPay trial participants for their time, not only their expenses
Shares Trials do not represent the people who get cancer, Trials enrol too few, too slowly.
- IdeaTravel, lodging and meals reimbursed as a standard line in every trial budget
Shares Trials do not represent the people who get cancer, Trials enrol too few, too slowly.
- IdeaPaid community advisory boards with power to change protocol burden
Shares Trials do not represent the people who get cancer, National Cancer Institute (NIH).