Only 7% of cancer patients in the U.S. participate in clinical trials, according to a report published Oct. 6 in JCO Oncology Practice.
Research from the report will be presented Oct. 10-11 at the 2025 American Society of Clinical Oncology Quality Care Symposium in Chicago, according to an Oct. 6 news release from the American Society of Clinical Oncology.
Authors of the report used the National Institutes of Health’s clinical trial registry to identify and analyze 10,142 U.S.-based cancer clinical trials conducted between 2008 to 2024.
Here are six things to know from the report:
- Of all the trials included in the report, 16.9% were federally funded and 83.1% were industry funded.
- Between 2010 to 2020, patient enrollment in industry-funded trials more than doubled, while federally funded clinical trial enrollment remained flat.
Patient enrollment in industry-funded trials is eight times greater than in federally funded trials. - Industry-funded trials were more likely to be conducted during phase 3 and to focus on a single-agent drug.
Here are the main differences the report found when comparing federally and industry funded cancer clinical trials in the U.S.:
| Trial type | Federally funded | Industry funded |
| Early-stage (phase 1 or 2) trials | 87.3% | 82% |
| Phase 3 trials | 12.7% | 18% |
| Rare cancers | 17.8% | 12.3% |
| Pediatric cancers | 16.2% | 5.1% |
| Single-agent drug trials | 50.8% | 79.9% |
| Complex multimodality drug or biological agent combinations alone | 20.2% | 7.7% |
| Complex multimodality drug or biological agent combinations with radiation | 11.0% | 1.5% |
| Complex multimodality drug or biological agent combinations with surgery | 2.6% | 0.2% |
| Complex multimodality drug or biological agent combinations with transplantation | 1.5% | 0.1% |
| Complex multimodality drug or biological agent combinations with combined modalities | 1.9% | 0.1% |
| Focus on dose de-escalation | 3.2% | 0.4% |
- Across all U.S. counties, 56% of cancer patients do not have clinical trials available at their care site. This number shifts depending on geographic area, with 86% of nonmetropolitan counties and 44% of metropolitan counties having no trial offerings.
Only 2% and 7% of counties with high cancer mortality and high social vulnerability, respectively, offer wide cancer clinical trials.
Cancer patients enrolled in a clinical trial spend an average of $600 per month for travel and lodging associated with trial participation.
- The median age of trial participants was more than six years younger than the age patients are typically diagnosed with disease.
Racial disparities exist between cancer prevalence and clinical trial participation, at 10% and 6%, respectively, for African American patients, and 7% and 3%, respectively, for Hispanic patients. - The report authors expressed concerns that healthcare professionals were abandoning or not starting careers in clinical cancer research due to uncertain federal funding and “inadequate mentorship and/or promotion opportunities,” which could lead to decreased clinical trial access.
Read the full report here.
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