2026 · Critical reviews in oncology/hematology · paywalled
From site-centered to patient-centered: Promises and challenges of decentralized clinical trials in oncology
Gentile et al.
The finding, in our words
This review suggests that decentralised clinical trials in oncology can improve patient participation and equity but face significant regulatory, logistical and digital hurdles. It concludes that these trials offer a flexible model dependent on specific clinical contexts rather than a universal replacement for conventional methods.
A paraphrase to the Library’s standard, never the abstract. The source is one link away and is always the authority.
Hybrid decentralized oncology trials are feasible in community hospitals beyond traditional networks, reducing logistical and financial burdens and enabling rapid initiation and patient referrals within three months.
A nationwide survey of 194 professionals across 140 Japanese hospitals found that geographic and logistical barriers limit access to comprehensive genomic profiling and genotype-matched trials, with over half of eligible patients declining participation due to travel distance; most institutions support telemedicine for consent and results and view DCTs as essential to improve equitable access.
In 50 cancer patients monitored at home with an Apple Watch for 28 days, a method that classified missing step data by gap duration and context produced the most reliable daily step estimates. Daily step counts on days with at least ten hours of wear time predicted time to first clinical event (p=0.068) and identified participants at lower hazard of mortality, with 83.3% accuracy for clinical event prediction, demonstrating that processed consumer wearable data can support remote monitoring in decentralised oncology trials.
During COVID-19, 95% of cancer trial sponsors adopted decentralised elements, with remote laboratory assessments used in 63% of trials, demonstrating that such methods can generate FDA-approvable data. Sponsors reported institutional policies as the main barrier, yet most plan to continue remote monitoring and telemedicine, indicating sustained viability for reducing patient burden.