ArticleThe oncologist2026
Telemedicine as a gateway to early-phase oncology trials: lessons from 14 000 patients and future directions for global access and equity.
Article in The oncologist, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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25 authors.
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Abstract
backgroundTelemedicine expanded rapidly during the COVID-19 pandemic, but its role in early-phase oncology trials remains uncertain. We evaluated its impact on recruitment, enrollment, equity, and access in a large phase I program. PATIENTS AND
methodsWe retrospectively analyzed patients seen for first consultation in the MD Anderson Phase I Program (2016-2023). Recruitment (consent) and enrollment (treatment initiation) were compared by visit type, race/ethnicity, and geography across pre-pandemic (2016-2019), pandemic (2020-March 11, 2023), and post-public health emergency (PHE; March-December 2023) periods. A chart review of 400 patients validated findings.
resultsOf 14 085 patients, 7247 were evaluated post-pandemic, with 36% (n = 2616) of first visits by telemedicine. Recruitment and enrollment rates were comparable between telemedicine and in-person visits (61.5% vs 62.6% and 37.5% vs 39.6%, respectively) in the post-2020 period. Hispanic patients used telemedicine more often than non-Hispanic (NH) white patients (43.8% vs 35.9%; P = .0002) and had higher enrollment (54.2% vs 39.4%; P < .0001) during this period. Rates were similar for NH Black vs NH White patients. Texas residents were more likely to use telemedicine than out-of-state patients (48.5% vs 22.8%; P = .0001). After the PHE ended, telemedicine increased among Texas patients (48%→56%) but declined among out-of-state patients (26%→12%).
conclusionsTelemedicine is a feasible and equitable strategy for early-phase oncology trial enrollment, with strong uptake among Hispanic patients. However, use declined among out-of-state patients after the PHE, underscoring cross-state licensure and reimbursement barriers to equitable access. Policy reforms are essential to preserve telemedicine as a permanent gateway to clinical trials and to broaden diversity in cancer research.
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