A recent study by researchers from The Univetsity of Texas MD Anderson Cancer Center, ASCO, and collaborating institutions evaluated the national landscape of geographic access to active triple-negative breast cancer clinical trials. The findings—published by Amin et al in Breast Cancer Research and Treatment—underscore significant variations in trial availability across rural regions and high-need areas, while highlighting the vital role of federal funding in expanding geographic access.
Key Data and Findings
Out of all U.S. counties, 76% had no active triple-negative breast cancer clinical trials available. Among all U.S. counties, 12% offered exclusively federally sponsored trials, 10% offered a mix of federally and nonfederally sponsored trials, and 2% offered only nonfederally sponsored trials.
Metastatic triple-negative breast cancer trials were less widely available than nonmetastatic trials. Only 63% of trial sites offered metastatic options (with just 9.4% of those sites offering four or more metastatic trials), compared to 93% of sites offering nonmetastatic trials.
Rural counties faced lower trial availability, with 90.2% lacking any available triple-negative breast cancer trials compared to 53.0% of metropolitan counties. Rural counties and those in the highest quartile of health vulnerability relied heavily on infrastructure support, with 80% of rural trial-offering counties and 73% of high health vulnerability counties depending exclusively on federally sponsored trials.
Regionally, women residing in the South were more likely to lack trial access in their county or a neighboring county compared to women in the Northeast.
Policy and Practice Implications
The authors emphasized that expanding access to clinical research involves addressing structural and geographic barriers. Expanding pragmatic trial designs, leveraging remote monitoring and telemedicine technologies, and preserving robust investment in federally funded networks like the National Cancer Institute’s National Clinical Trials Network (NCTN) and NCORP are highlighted as important steps to improve clinical trial reach.
DISCLOSURE: For full disclosures of the study authors, visit link.springer.com.
