Whitepaper: Advancing Neuro-Oncology Clinical Trial Access

Advancing Neuro-Oncology Clinical Trial Access: Expert Insights From the EANO Roundtable

Table of Contents

• Barriers to neuro-oncology clinical trial access across Europe
• Geographical disparities driving unequal access
• Gaps in awareness and communication impacting trial accessibility
• Operational and logistical barriers to patient enrollment
• Genomic data availability and testing complexity undermining timely trial access
• How are countries adopting real-world solutions to improve access?
• The opportunity for digital transformation and closer collaboration in trial access

Barriers to neuro-oncology clinical trial access across Europe

Despite major advances in neuro-oncology, access to clinical trials across Europe remains highly fragmented and inefficient. Recent data highlights the scale of the problem:

• 52% of clinical trial sites report that recruitment inefficiencies limit their ability to open new trials¹.
• 37% of sites under-enroll while 11% fail to enroll any patients².
• In the UK, only 3% of neuro-oncology patients are treated in clinical trials³.
• 95% of cancer patients believe trial access is important³

While patient willingness is high³, systemic barriers continue to hinder trial participation. To better understand the underlying causes and identify practical solutions, myTomorrows convened a Neuro-Oncology Expert Roundtable during the EANO 2025 congress with ten leading experts from the United Kingdom, Spain, Germany, Italy, the Netherlands, Austria, and Switzerland. The discussion revealed consistent challenges:

• unequal access between regions
• slow and inconsistent workflows
• poor communication between referring physicians and trial sites
• fragmented infrastructure.

This blog summarizes the expert insights from the roundtable and outlines how coordinated efforts and digital solutions can help close the gap between patients, physicians, and clinical trials.

Geographical disparities driving unequal access

Access to neuro-oncology trials is heavily influenced by geography; creating inequity often referred to as ‘postcode lottery access’⁴. Patients treated at large academic hospitals are far more likely to be considered for trial participation than those in smaller regional centers. Most trials are clustered in major cities, forcing rural patients to travel long distances.

• In Spain, some regions subsidize travel and accommodation for clinical trial participants, while others at similar distances provide no support at all.
• In Italy, most neuro-oncology centers are concentrated in the north, leaving southern patients with limited options.
• In Germany, remote physicians and patients struggle to find accurate trial information
• In the United Kingdom, whole genome sequencing pathways are too long, especially for remote sites.
• Even in geographically smaller countries like Austria and Switzerland, patients in local hospitals are referred too late, or never considered for trial enrollment.

These disparities mean that trial participation often depends more on a patient’s residence than on clinical eligibility.

Gaps in awareness and communication impacting trial accessibility

A lack of awareness among both physicians and patients remains a major barrier. Referring physicians at smaller hospitals may not routinely check for available trials early in the disease course. Instead, standard first- or second-line treatments are prescribed without discussing research options, leading to late referrals when patients may no longer qualify.

Communication between community hospitals and academic centers is typically one-directional. Referring physicians often receive no feedback on outcomes or enrollment, contributing to mistrust and reducing future referrals.

Meanwhile, patients increasingly search online for trial opportunities, but publicly available information is outdated or inaccurate. Many trial listings lack valid contact details or do not reflect true recruitment status. For example, in the UK, 24% of neuro-oncology trial sites were found to be unreachable based on contact information published on clinicaltrials.gov⁵, and 34% of sites listed incorrect recruitment statuses⁵.

These issues lead to false expectations, missed opportunities, and unnecessary workload for trial sites.

Operational and logistical barriers to patient enrollment

With the shift toward precision medicine in recent years, clinical trials have become increasingly complex⁵. As therapies become more targeted and personalized, regulatory requirements have likewise intensified. Within this evolving landscape, the roundtable participants identified several operational barriers that further constrain patient enrollment:

• delayed molecular/genomic results
• complex study protocols and eligibility criteria
• staffing shortages at academic centers
• financial uncertainty for patients
• limited infrastructure in smaller hospitals

Together, these factors create friction throughout the patient journey and contribute to slow recruitment and study delays.

Genomic data availability and testing complexity undermines timely trial access

Molecular profiling is increasingly essential for trial eligibility, but current workflows are often too slow to be clinically useful. Tissue availability is not always clear, and sequencing may occur too late.

In one case discussed, a glioblastoma patient was tested for an NTRK fusion, but the relevant trial had already closed by the time results were returned.

Testing approaches vary widely across Europe. In many hospitals, comprehensive molecular testing is performed only after multiple treatment failures, limiting eligibility. Experts emphasized the need for earlier and standardized testing, with pathology teams playing a more active role.

Some centers are making progress; for example, certain UK hospitals now include H3K27M mutation testing as part of routine diagnostics for glioma patients.

How are countries adopting real-world solutions to improve access?

While the challenges are shared across Europe, some countries are beginning to pilot new models to improve coordination:

• United Kingdom: A nationwide panel has been proposed to refer patients to a centralized expert group for real-time trial availability and eligibility matching.
• Spain: A manually curated national newsletter shares investigator-submitted trial updates. This boosts awareness but requires continuous funding and administrative effort to stay current.
• Netherlands: Leading centers host regular online meetings to update the community on new and ongoing trials, followed by summary notes outlining trial status and key eligibility criteria.
• Italy: Regional webinars connect nearby centers to share current trial status and recent results, providing a useful channel for keeping the community informed.

These initiatives show that centralized coordination, even if initially manual, can make trial information more visible and actionable.

The opportunity for digital transformation and closer collaboration in trial access

The European Neuro-Oncology roundtable highlighted that inequitable trial access is not driven by lack of interest to participate but by a lack of infrastructure and coordination. Both physicians and patients want to engage in clinical research, but systemic inefficiencies can make participation unnecessarily difficult.

The expert consensus was clear: the challenges can be addressed through smarter use of digital tools and closer collaboration among hospitals, sites, sponsors, and health tech innovators such as myTomorrows. By combining technology, standardized processes, and education, Europe can move toward a future where every eligible neuro-oncology patient, regardless of geography, has access to the latest research opportunities and emerging therapies.

This is where myTomorrows can play a central role. The myTomorrows platform and Patient Navigator services directly tackles several of the issues raised by the experts:

• Improving visibility: Enabling sites to structurally and easily share an overview of their clinical trials, provide up-to-date trial information or referral requirements to their network and referring physicians.
• Streamlining referrals: Providing a secure, and seamless pathway for physicians to refer patients and share the right information, reducing unnecessary emails and delays.
• Enhancing efficiency: Automating the pre-screening process to precisely match trial eligibility and allowing trial sites to keep track of referrals and gain funnel insights.
• Qualifying and supporting patients: Ensuring patients are informed and qualified prior to referral with the support from multilingual Patient Navigators with medical backgrounds, improving enrollment rates and alleviating burden on site.

By connecting community hospitals, trial investigators, and sponsors within one centralized ecosystem, myTomorrows aims to make clinical trials more visible, efficient and inclusive.

About the author

Daniël Groeneweg

Senior Medical Community Manager at myTomorrows

Daniël is a Senior Medical Community Manager at myTomorrows, where he leads the implementation of myTomorrows’ AI-powered clinical trial platform across multiple countries and medical communities. With specialized expertise in neuro-oncology, he works closely with physicians, from international KOLs to clinical nurse specialists, to streamline access to clinical research.

Daniël brings over 10 years of experience from the healthcare and medical research industry. He holds a Master’s degree in Biomedical Sciences and has a background in fundamental research. He has worked on phase II–III immunology and oncology clinical trials and has contributed to the development of investigator-initiated studies in cardiology and respiratory medicine across the EU, collaborating with leading key opinion leaders. His previous experience includes roles as a Clinical Research Associate (CRA) at AbbVie and as a Global Medical Affairs CRA at Omron Healthcare.