A statewide survey assessing how oncologists navigate the cancer clinical trial landscape.

Abstract

125 Background: Cancer clinical trials remain underutilized in oncology practice. Finding trials and efficiently screening patients for eligibility remains a major barrier to trial enrollment. We surveyed community and academic oncologists across Minnesota to assess baseline trial utilization patterns, system infrastructure, and referral workflows. Methods: A statewide cross-sectional study was administered to all 375 board-certified oncologists across Minnesota between October and December 2025. Likert-type, multi-select, and open-ended responses assessed clinical practice setting, trial-referral behaviors, and trial enrollment barriers. Responses were summarized using descriptive statistics, and Fisher's exact tests were used to compare categorical responses between oncologists practicing at academic versus community organizations. Qualitative analysis was performed on open-ended text. Results: Of 375 potential responders, 86 completed the survey (23% response rate), of whom 80 reported at least one day of patient care per week and were included in the analytic sample. 51% reported practicing in an academic setting and 49% at community sites. Nearly 70% reported being “very confident” when discussing clinical trials, but it varied slightly between academic and community oncologists (Table 1). Academic oncologists reported “almost always” seeking out trials for patients in need of a new treatment plan more frequently than community peers (54% vs 39%). However, only 12% of academic oncologists report looking at websites from outside organizations. Nevertheless, most respondents agreed that “if insurance were not an issue and your patient was interested and eligible”, they would recommend referring their patient to a different health system for an appropriate trial. Perceived barriers were similar between practice settings: 84% of all respondents agreed that finding relevant information to enroll patients in clinical trials took “a lot of effort,” and 65% felt “frustrated” during the trial search process. Conclusions: While Minnesota oncologists report confidence discussing clinical trials, structural barriers limit efficient trial utilization. Time-consuming and frustrating search processes contribute to this disparity. Trial-searching behaviors differ between community and academic settings, highlighting a critical and systemic gap within current workflows. Thus, a solution that addresses these systemic barriers is needed to alleviate clinician administrative burden and enhance trial participation. All (n = 80) Academic (n = 41) Community (n = 39) n (%) n (%) n (%) P-value “Very confident” discussing trials 55 (69) 31 (76) 24 (62) 0.18 “Almost always” seeks trials when patient need new treatment 37 (46) 22 (54) 15 (39) 0.047 Search websites of other organizations for trials 26 (33) 5 (12) 21 (54) <0.001 Very/somewhat likely to refer externally 74 (93) 37 (90) 37 (95) 0.68