Improving Access to Oncology Clinical Trials: Insights from the myTomorrows European Physician Advisory Board

Table of Contents

• Common clinical trial access themes across Europe
• The Netherlands: Navigating rarity and complexity of clinical trials
• Switzerland: Awareness isn’t the issue — compliance and coordination are
• Belgium: Information gaps and transparency constraints
• Germany: A data-driven challenge
• Spain: The neuro-oncology gap
• The United Kingdom: Building awareness and trust
• The Consensus Among Experts
• Moving forward: A collaborative path

Research shows that when eligible cancer patients are presented with clinical trial options, more than 50% enroll¹. In practice, however, the actual number of patients joining clinical trials is significantly lower. A study conducted by the National Brain Tumor Society (NBTS) found that at the time of diagnosis, only 24% of patients were informed about the possibility of clinical trials¹, highlighting a notable gap in terms of awareness and access to relevant clinical trials.

On Tuesday, April 1^st 2025, myTomorrows hosted a European Advisory Board meeting, bringing together a panel of expert neuro-oncolocy physicians from across the Netherlands, Belgium, Germany, Switzerland, Spain and the UK. The group included professionals from fields of neuro-oncology, oncology, neurosurgery, hematology, as well as the founder of UK’s leading brain tumor support group. The goal of the meeting was to uncover common challenges and country-specific nuances in accessing and referring patients to clinical trials — particularly in the context of oncology and neuro-oncology — and to identify practical ways to bridge those gaps.

Across the board, participants agreed: while clinical trials hold opportunities for patients with limited treatment options, systemic and logistical hurdles often prevent eligible individuals from participating. These barriers affect patients, physicians, and trial sites alike — but they also differ in nature depending on the healthcare system, geography, and available infrastructure of each country.

In this blog we’ll cover both the challenges and opportunities identified by physicians at a country-level, as well as pathways and strategies which may help to improve access to clinical trials across Europe.

Common clinical trial access themes across Europe

A few themes rang true across every country represented. First and foremost was a lack of awareness — among physicians about ongoing and recruiting studies, and among patients about the existence of clinical trials. This was closely followed by logistical barriers, such as travel limitations, language and administrative complexity, and slow or inconsistent communication between referring physicians and study investigators.

Physicians also reported a shortage of time and supportive staff, both of which are critical for screening, referral, and patient follow-up. Meanwhile, complex and overly strict inclusion and exclusion criteria frequently limit enrollment of patients who might otherwise benefit from participation  — especially those with comorbidities ties or neurologic impairments.

Despite these shared struggles, the conversation also brought to light distinct country-specific barriers in each country, highlighting the need for tailored solutions.

The Netherlands: Navigating rarity and complexity of clinical trials

In The Netherlands, a key issue is physician and patient unfamiliarity with clinical trial opportunities. Referring physicians, including their patients — don’t realize that studies exist or that they might be eligible. Even when they do, travel restrictions and cognitive or social frailty often hinder participation. In the field of neuro-oncology, tumor rarity, comedications, and strict eligibility criteria further limit trial access.

For physicians, time constraints and a lack of information about current trials prevent them from engaging patients in experimental research. Study sites, on the other hand, face administrative hurdles in both referring and accepting patients, and report in some cases a 50% rejection rate due to trial inclusion and exclusion factors. Increasing trial awareness needs to be paired with more flexible study criteria and smoother referral pathways.

Switzerland: Awareness isn’t the issue — compliance and coordination are

In Switzerland, physicians indicate that logistical and financial constraints still pose challenges for patients — especially for those who may lack motivation to travel regularly. However primarily, experts highlighted greater support is needed for cross-border patients who may find navigating the local health system daunting. Clear guidance on transport, accommodation, and reimbursement policies could help drive broader adoption and participation.

Furthermore, sites in Switzerland noted a behavioral lack of support for trials from referring physicians — often due to fear of “losing” their treating patient. To manage this, a clearer, standardized communication system between referring physicians and study teams could help bridge this trust gap and support earlier engagement.

Belgium: Information gaps and transparency constraints

In some cases, experts noted that Belgian patients face knowledge gaps about their diagnosis, which can limit their ability to explore appropriate trials.

Whilst a need for further guidance about cross-border trials exists, importantly, Belgian physicians noted that websites like clinicaltrials.gov can often be out of date. This creates a knock-on effect of increased workload and time spent searching for relevant trials. By improving database transparency and real-time recruitment status, efficiency could be improved significantly.

Germany: A data-driven challenge

In Germany, effectively matching patients to clinical trials can be complicated by the fragmentation of diagnostic data across systems. Without a centralized or comprehensive view of each patient’s medical history — including tumor staging, comorbidities, and prior treatments — assessing trial eligibility can become more resource-intensive and time-consuming for clinical teams. Communication between referring physicians and principal investigators must be both standardized and swift to avoid missing trial windows. Similarly to other countries, physicians struggle with fragmented databases and a lack of clarity around active studies, as well as needing clearer guidance for cross-border trials.

At the site level, time-critical coordination is essential. Delays in assessing eligibility or in getting confirmation from the referring team can result in missed enrollment opportunities.

Spain: The neuro-oncology gap

Spain’s challenges are particularly acute in neuro-oncology. Physicians indicate that patients often deal with neurological and cognitive impairments, making travel and participation logistically and financially unmanageable. This results in underrepresentation of real-world patients and trials that lack generalizability.

Furthermore, there is a scarcity of brain tumor trials, and teams often lack specific training to navigate complex protocols or adaptive trial designs. Staff shortages further limit the adoption of time-saving technologies like AI, despite their potential to improve screening and enrollment.

In parallel with other European countries, physicians cite challenges around awareness of available trials due to disjointed databases and limited integration with trial sites. With narrow enrollment windows and complex eligibility requirements, delays can easily disqualify potential candidates.

The United Kingdom: Building awareness and trust

In the UK,  as shared by brainstrust, one of the most prominent barriers is patient awareness about clinical trials among physicians and their patients and what they entail. Patients often lack crucial information about the existence of trials and may misunderstand their purpose and processes, leading to uncertainty and confusion.

Beyond informational challenges, patients frequently grapple with personal concerns, for example how their roles within their family or day job will be affected, or simply their overall mental and emotional wellbeing. This interplay of complex personal considerations highlights the need for trust to be built between patients and healthcare professionals, so that patient concerns can be sensitively discussed and addressed.

The discussion emphasized the need for confident, informed conversations around clinical trials, supported by appropriate patient-friendly educational materials. Strengthening trust through transparent and empathetic dialogue is essential for improving trial participation rates and patient satisfaction in the UK.

The Consensus Among Experts

The advisory board achieved a consensus on several overarching issues and opportunities affecting clinical trial access and patient participation across Europe:

Improving patient access to oncology clinical trials

• Experts agree that the increasing specificity of brain tumor subtypes significantly complicates patient eligibility for clinical trials.
• In order to facilitate smoother trial participation for patients, measures including decentralized blood testing were suggested to reduce travel and logistical burdens.
• The board highlighted the need for standard patient-friendly educational materials, that clearly communicate the nature and scope of trials to patients; noting that this can inform greater trust and certainty in the patient-physician relationship.
• Further, the introduction of standardized forms which physicians can use to document anticipated patient treatment or participatory hurdles – the like of which is currently available in Switzerland but not universally, were identified as crucial tools for enabling improved patient clarity and informed consent.

 Navigating clinical trial systems for oncology

• Physicians consistently feedback that fragmented clinical trial search systems hinder the exploration and access process – having a system which provides easily accessible information about current trials would save time and improve awareness hurdles.
• There is widespread concern over lack of patient clinical trial participation, partly driven by institutions prioritizing financial considerations over academic trials.
• Opportunities for cross-border trial participation can be lost without clear guidance relating to costs, insurance, accommodation and travel.

Optimizing clinical trial site operations

• Unrealistic trial designs with overly ambitious patient enrollment targets and logistical complexities were recognized as frequent barriers to successful trial implementation-
• Experts advocate for greater cross-functional collaboration and integration with trial sites to improve efficiency and help address timely eligibility assessments.
• Standardized communication tools between referring physicians and sites can expedite recruitment, enrollment, address high volumes of rejections and lighten administrative burdens on site staff.

Moving forward: A collaborative path

The advisory board discussion underscored the urgent need for better trial visibility, more flexible and transparent eligibility criteria, and greater infrastructure support across Europe. Physicians need intuitive, real-time tools to identify recruiting trials and clear communication pathways with sites. Patients need accessible information and logistical assistance to pursue these opportunities — regardless of geography or socioeconomic status.

At myTomorrows, we are committed to overcoming these barriers through collaboration with diverse stakeholders. By incorporating patient-centric approaches, we aim to make clinical trial access more equitable, transparent, and effective across Europe and worldwide.

With our multi-stakeholder AI-powered platform we’re able to seamlessly connect patients, physicians and sites; matching eligible patients to relevant clinical trials with an industry-leading 98% accuracy. Through expert support, we offer patient navigation services which provide guidance to patients, families and caregivers about the logistics, risks and potential benefits of clinical trial participation. And via our community outreach, we work with patient advocacy groups, to strive for increased awareness of the clinical trial landscape, ultimately supporting patients and treating physicians with up-to-date and reliable information.

How can we help?

If you are a treating physician seeking clinical trials for your patient or a clinical researcher seeking improved operational efficiency as well as high-quality referrals, we are here to ease the burden.

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