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- Posted December 23, 2025
One Roadblock Keeps Most Cancer Patients From Joining Clinical Trials, Experts Say
Cutting-edge cancer drugs are being tested all the time, potentially saving or extending the lives of patients who take part in clinical trials.
So why don’t more cancer patients enroll in these trials for experimental drugs?
It comes down to money, a new study says.
Financial factors — not race or background — most strongly predict who will participate in cancer research studies, researchers reported Dec. 17 in the Journal of the National Comprehensive Cancer Network.
“Clinical trials save lives, but financial barriers prevent too many patients from participating,” said lead researcher Weichuan Dong, an assistant professor at Weill Cornell Medicine and Houston Methodist.
“Addressing the real-world costs patients face, like transportation, child care and lost wages, can make trials more equitable and ensure advances in cancer care benefit everyone,” Dong said in a news release.
About 1 in 5 cancer patients participate in clinical trials, researchers said in background notes.
This low participation rate not only means that many miss out on potentially lifesaving experimental treatments, but that treatments which prove to be breakthroughs take longer to receive U.S. Food and Drug Administration approval and reach patients.
For the new study, researchers analyzed the records of more than 12,000 patients receiving cancer care from University Hospitals in Northeast Ohio.
Of those patients, only 5% participated in a clinical trial for cancer treatment.
Results initially showed that Black patients were 30% less likely to enroll in clinical trials than white patients. But after researchers took income into account, that difference became no longer statistically significant.
Overall, higher income increased a person’s odds of joining a clinical trial up to 67%, researchers found.
Likewise, lower-income patients insured through Medicaid were 29% less likely to enroll in a clinical trial than those with private insurance.
Property ownership and financial stability also were powerful factors influencing who joined a cancer trial, researchers said.
These results show that clinical trial participation could be boosted if researchers focused on addressing the financial realities of patients by:
Reimbursing them for travel and lodging expenses
Compensating them for lost wages during treatment
Providing child care assistance
Offering transportation vouchers
“For many patients, participation comes down to logistics and money,” senior researcher Dr. Richard Hoehn, an assistant professor of surgical oncology at Case Western Reserve School of Medicine in Cleveland, said in a news release. “Addressing those challenges is one of the most direct ways to make trials more inclusive.”
Researchers are now expanding this study to include other Ohio medical centers and networks.
“This larger study, expected to be published in early 2026, will provide the first comprehensive map of clinical trial enrollment among cancer patients — identifying where structural barriers prevent access to potentially life-saving treatments,” Dong said.
“We’re working to map ‘clinical trial deserts’ and understand how geographic and structural barriers influence access across urban, suburban and rural communities,” he concluded.
More information
The National Cancer Institute has more on finding a clinical trial for cancer treatment.
SOURCES: Case Western Reserve University, news release, Dec. 18, 2025; Journal of the National Comprehensive Cancer Network, Dec. 17, 2025
