Addressing Physician Barriers to Trial Enrollment: ASCO 2025 Study Published in Nature Reviews Clinical Oncology

Charles Jiang, Medical Oncologist at UT Southwestern, shared a post on X:

“Today is the last day of ASCO25! Thrilled that our NatureRevClinOncol commentary on empowering oncologists for clinical trial access went live today!

We’ve all seen it: a small group of oncologists often enrolls the majority of patients, but why?

While patient willingness is high (>50% if informed by us oncologists! ), enrollment remains low (~7% ). The focus often misses a key factor: our oncologists . It’s not just about asking us to ‘do more’ or ‘put one more pt’.

In our NatureRevClinOncol piece, we argue for a systemic approach using the COM-B model (Capability, Opportunity, Motivation) from behavioral science. This framework helps understand and address challenges limiting our participation in trial enrollment.

Let’s explore it!

C = Capability: Do we have the necessary knowledge, skills and confidence? This means digesting complex protocols efficiently in busy clinic, effective risk-benefit communication training (especially with pt with low health literacy) and staying updated on trial portfolios.

O = Opportunity: Is our environment enabling? Overwhelming admin demands leave little time. We need institutional support: dedicated trial navigation teams, protected research time in clinic templates & user-friendly trial databases so we have to take extra efforts!

M = Motivation: What drives us to prioritize trial enrollment? Are these trial patient-centered, pragmatic and with reasonable control? Meanwhile, extra workload demands need acknowledgment beyond academic promotion, especially for community MDs. Recognition matters!

Ultimately, the goal is to create systems that empower us to ‘do better,’ not just ‘do more’. This means providing the tools, time, and motivation so we can present EVERY viable avenue for the best patient care.

My ASCO, Conquer Cancer, CDA-supported research will further explore these physician-level factors. Specifically, it aims to understand the variance in enrollment behaviors among oncologists and co-develop tools to support us, building on this framework.

So proud of this NatRevClinOncol commentary. Huge thanks to my mentors/co-authors Tian Zhang, Ryan Nipp, and to Dr.Helen H. Moon for her immense help and penetrating insights that substantially elevated our manuscript!”

Tian Zhang, Associate Director of Clinical Research at the Simmons Comprehensive Cancer Center, shared Charles Jiang’s post on X. adding:

“Great to see this NatRevClinOncol commentary published for clinical trial access and helping our oncologists incorporate clinical trials into their practices.

Was fantastic to work on this with Charles Jiang.”

Shaalan Beg, Senior Advisor for Clinical Research at the National Cancer Institute (NCI), shared Tian Zhang’s post on X, adding:

“There are many barriers to clinical trial access.

We have to acknowledge that us physicians are part of the problem.

This insightful review provides a framework for studying (and addressing) factors influencing physician referrals to clinical trials.”

Charles Jiang shared Shaalan Beg’s post on X, adding:

“Thanks for highlighting! Most oncologists want to help patients join trials-but it’s not just about ‘low awareness’ or “simply adding another patient”.

We need real support and systems that address the complex barriers we face.

Goodwill isn’t enough-action is.”

Title: Empowering oncologists: a practical approach to overcoming barriers to clinical trial enrolment

Journal: Nature Reviews Clinical Oncology

Authors: Changchuan Jiang, Ryan D. Nipp, Tian Zhang

Read the full article.

Read OncoDaily’s Special Articles about ASCO 2025:

Highlights from ASCO 2025 Day 1

Highlights from ASCO 2025 Day 2

Highlights from ASCO 2025 Day 3

Highlights from ASCO 2025 Day 4