Disparities in the availability of and access to neuro-oncology trial-supporting infrastructure in the United States

We conducted an extensive assessment and quantification of the reach of the oncology clinical trial-supporting infrastructure in the United States. Although our primary focus was on identifying avenues to expand the reach of neuro-oncology clinical trials, we considered infrastructure layers with important implications for broader cancer research and care. Specifically, we examined the geographic, population, and socioeconomic reach of national collaboratives (including more than 1500 institutions); more than 600 academic oncology and neurosurgery training programs; and networks of more than 25 000 individual neuro-oncology, neurosurgery, and general oncology (including hematology, medical, and gynecological oncology; surgical oncology; and radiation oncology) clinicians. Our study found that more than 57% of the US population lacks direct access to trial-supporting infrastructure. More than 71% of the locations with infrastructure are urban, and more than 72% are in socioeconomically advantaged areas. Our findings reveal critical disparities in oncology care access, and we suggest actionable strategies to optimize and expand the existing infrastructure's reach.