Advancing Clinical Trial Access and Patient Care Through Innovative Partnerships that Support Cancer Care Teams

The greatest advances in science and medicine are only as good as their availability to those who need them. Even a cure for cancer would only truly be a cure if patients could access it.

Approximately 32 million people in the United States live in counties that have no oncologist, and nearly 14% of people live more than 3 hours from an NCI-Designated Cancer Center or satellite facility. (1,2) For a healthy person, a long drive may be tedious or tiring; for a cancer patient awaiting care or undergoing treatment, that same journey often presents additional challenges. Even those who can travel to a hospital or clinic may arrive to find limited infrastructure and understaffed care teams—partly because of smaller hiring pools in the area. (3) These smaller teams often do not have the resources to offer cutting-edge cancer treatments via clinical trials. Though clinical trials are essential for the development of new treatments and are a critical part of cancer care, they demand time and effort that overstretched care teams may not be able to provide.

As cancer treatments have improved, they have also become more complex. These advancements require specialized care tailored to patients’ needs and diagnoses. Large cancer centers can support specialized teams capable of delivering this care for an array of cancer types and subtypes. With fewer cancer cases, many rural and community health centers cannot financially maintain the same breadth of in-house expertise. As a result, care teams at these locations must provide care for all cancer types, which places a strain on clinical staff and may leave patients without access to cutting-edge care. (4)

Without sufficient clinical and research staff, millions of Americans cannot benefit from advancements in cancer detection, treatment, and survivorship care. Workforce challenges were the focus of the Panel’s 2026 report to the President. In their report (1), Panel members Dr. Mitchel Berger and Dr. Carol Brown identified three opportunities for partnerships to support care teams:

• Facilitating mentorship for providers
• Enabling patients to receive more care closer to home
• Improving access to cancer clinical trials (1)

Each of these opportunities could be realized through partnerships that use a hub-and-spoke model, in which centralized resources—from specialized knowledge to clinical trial enrollment teams—are connected to local providers, patients, and sites.

The Panel’s proposed solutions represent some of the many actions that can be taken now to extend the reach of existing resources, improve efficiency, and help build a strong workforce that is ready to deliver timely, high-quality cancer care to all people in the U.S.

Partnerships Facilitate Mentorship for Providers

Providers need extensive training, professional guidance, and continuing support to deliver quality cancer care; yet accessing these vital resources can be challenging for clinical staff in rural and remote areas. Rather than relying on a single institution or organization, the most successful approaches to addressing these needs are those that forge connections between multiple institutions and experts to advance patient care. The hub-and-spoke model for mentorship connects local providers virtually with specialists to discuss and understand treatment options and diagnostics. Project Extension for Community Healthcare Outcomes (ECHO), for example, connects multidisciplinary specialist teams with community providers in rural and underserved areas to enable better cancer prevention, screening, and treatment. (5,6)

Partnerships Enable Patients to Receive More Care Closer to Home

Other hub-and-spoke partnerships may involve the patient directly, by allowing them to receive basic care from their local provider and travel only when they need more complex care. The Lakewood Health System Rural Oncology Home model in Minnesota, for example, strengthens connections and exchange between community providers, academic cancer centers, and specialty care centers, ensuring patients can access crucial care with lower disruption to their lives and health. These partnerships are supported by multiple sectors, including professional organizations, health care systems, and academic institutions. (3,7)

Partnerships Improve Access to Cancer Clinical Trials

Clinical trials are the path to both cancer research breakthroughs and improved health. However, many rural and community health centers do not have the resources or the staff to offer patients access to cutting-edge treatments via clinical trials. Through the hub-and-spoke model, research institutions can partner with community sites to make clinical trials available where patients regularly receive care. One way to do this is to provide administrative support for clinical trials conducted at those sites. NCI’s Virtual Clinical Trials Office is a team of remote research staff who support clinical trial screening, enrollment, and implementation in communities with fewer resources. (8)

A patient’s ability to participate in a potentially lifesaving clinical trial or receive timely, high-quality cancer care should not be limited by their street address or the community they call home. Cross-institutional partnerships can help extend the reach of cancer care to all communities in the United States.