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What Is Ailing Oncology Clinical Trials? Can We Fix Them?

North East Cancer Center, Health Sciences North, Northern Ontario School of Medicine (NOSM U), Sudbury, ON P3E5J1, Canada
Department of Medicine, Division of Medical Oncology, The Ottawa Hospital Cancer Centre, University of Ottawa, Ottawa, ON K1H8L6, Canada
Tom Baker Cancer Center, Alberta Health Services, Calgary, AB T2N4N2, Canada
Cumming School of Medicine, University of Calgary, Calgary, AB T2N4N2, Canada
Princess Margaret Cancer Centre, University Health Network, University of Toronto, Toronto, ON M5G2M9, Canada
Author to whom correspondence should be addressed.
Curr. Oncol. 2024, 31(7), 3738-3751;
Submission received: 27 May 2024 / Revised: 21 June 2024 / Accepted: 24 June 2024 / Published: 28 June 2024


Evidence from phase three clinical trials helps shape clinical practice. However, a very small minority of patients with cancer participate in clinical trials and many trials are not completed on time due to slow accrual. Issues with restrictive eligibility criteria can severely limit the patients who can access trials, without any convincing evidence that these restrictions impact patient safety. Similarly, regulatory, organizational, and institutional hurdles can delay trial activation, ultimately making some studies irrelevant. Additional issues during trial conduct (e.g., mandatory in-person visits, central confirmation of standard biomarkers, and inflexible drug dosage modification) contribute to making trials non-patient-centric. These real-life observations from experienced clinical trialists can seem nonsensical to investigators and patients alike, who are trying to bring effective drugs to patients with cancer. In this review, we delve into these issues in detail, and discuss potential solutions to make clinical trials more accessible to patients
Keywords: clinical trials; barriers; eligibility; trial activation; trial conduct clinical trials; barriers; eligibility; trial activation; trial conduct

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MDPI and ACS Style

Mittal, A.; Moore, S.; Navani, V.; Jiang, D.M.; Stewart, D.J.; Liu, G.; Wheatley-Price, P. What Is Ailing Oncology Clinical Trials? Can We Fix Them? Curr. Oncol. 2024, 31, 3738-3751.

AMA Style

Mittal A, Moore S, Navani V, Jiang DM, Stewart DJ, Liu G, Wheatley-Price P. What Is Ailing Oncology Clinical Trials? Can We Fix Them? Current Oncology. 2024; 31(7):3738-3751.

Chicago/Turabian Style

Mittal, Abhenil, Sara Moore, Vishal Navani, Di Maria Jiang, David J. Stewart, Geoffrey Liu, and Paul Wheatley-Price. 2024. "What Is Ailing Oncology Clinical Trials? Can We Fix Them?" Current Oncology 31, no. 7: 3738-3751.

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