Breast Cancer Trial Access Often Missing in Community

Most patients receive care in community clinics, but trial enrollment there currently lags behind academic averages.

Updated on Oct. 26, 2026 in Cancer

A wide, sunlit, and modern outpatient clinic corridor with rows of empty seating and clean, minimal architectural features. — A new analysis indicates that 85 percent of patients with advanced breast cancer in the U.S. receive care in community settings, highlighting an urgent need for expanded clinical trial access. AI Illustration. Upload story photo >

Live Poll

Should medical researchers move clinical trials into community clinics to increase patient access?

A new analysis reveals that 85 percent of U.S. patients with advanced hormone receptor-positive, HER2-negative breast cancer receive care in community settings. This finding highlights a significant gap in research reach, as community programs currently see much lower clinical trial enrollment compared to broader averages.

Why it matters

Clinical research programs must increasingly move into community clinics to match where most patients actually receive care. Failing to adapt trial sites to these settings risks slowing the development and delivery of potentially life-saving new cancer treatments.

Phesi analyzed clinical and registry data for 47,011 patients, finding that only 4.1 percent of those in community settings enroll in clinical trials compared to a 7.1 percent rate for all cancer types. The specific factors hindering trial participation in these non-academic settings remain under investigation.

The players

Phesi

A clinical development data and analytics company that uses its platform to aggregate real-world patient records for trial optimization.

The details

The analysis leveraged the Trial Accelerator platform, which aggregates real-world data from 379 million patients to help sponsors map where potential study participants are receiving care. Researchers found that while HR-positive breast cancer patients primarily use community hospitals, academic centers are more likely to treat patients with triple-negative breast cancer. By matching site selection to actual patient footprints, sponsors aim to improve trial accessibility.

2024: US analysis of clinical trial enrollment rates was conducted.
October 26, 2026: Phesi released the study findings regarding breast cancer treatment settings.

Health Landscape

Clinical trial development is increasingly moving toward decentralized models to capture a more representative patient population. The use of the Trial Accelerator platform marks a strategic shift from relying solely on academic centers to integrating community clinics into the research pipeline.

Patients with breast cancer should feel empowered to ask their oncologist if their treatment center participates in or has access to clinical trial networks. Discussing research opportunities with a physician can help you understand if a trial is a suitable option for your specific care plan.

The takeaway

The majority of breast cancer care happens outside of academic hubs, making community clinics essential for the future of clinical research. If you are managing an advanced cancer diagnosis, ask your care team whether your clinic offers pathways to join clinical trials.