Inequities in enrollment across clinical trial phases and the need for a Spanish perspective

Early phase clinical trials (EPCT) are essential for evaluating new cancer treatments. However, disparities in patient enrollment persist, especially affecting older adults, minority groups, and individuals of lower socioeconomic status. In Spain, despite its leading role in European clinical research, systematic analysis of inequalities in EPCT participation remains underexplored. This narrative review identifies and discusses key barriers affecting patient access to EPCTs in Spain, including strict eligibility criteria, socioeconomic and geographic barriers, differences in hospital resources, and biases among clinicians when selecting patients. Recommendations provided include revising eligibility criteria, improving training for healthcare professionals, enhancing referral networks, providing targeted education for patients, and addressing socioeconomic and geographic constraints. Addressing these barriers is essential to ensure equitable EPCT participation in Spain and to improve overall cancer outcomes.

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Publication Details

Journal
Clinical & Translational Oncology
Published
2026-06-09
DOI
https://doi.org/10.1007/s12094-026-04428-z
Primary Topic
Ethics in Clinical Research
Type
article
Field-Weighted Citation Impact
0.00

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article

Inequities in enrollment across clinical trial phases and the need for a Spanish perspective

J. Esteban-Villarrubia, Juan Martín-Liberal, Patricia Palacios Ozores, Cristina Serrano‐Gómez et al.
Clinical & Translational Oncology
Ethics in Clinical Research
article

Inequities in enrollment across clinical trial phases and the need for a Spanish perspective

J. Esteban-Villarrubia, Juan Martín-Liberal, Patricia Palacios Ozores, Cristina Serrano‐Gómez, Aitana Calvo, Monica Guillot Morales, Regina Gironés Sarrió, M. Vieito, Javier Torres-Jiménez, Javier David Benitez Fuentes, Ana I. Ruiz-Casado, Javier García Corbacho, Elena Garralda, Víctor Moreno
article en

Abstract

Early phase clinical trials (EPCT) are essential for evaluating new cancer treatments. However, disparities in patient enrollment persist, especially affecting older adults, minority groups, and individuals of lower socioeconomic status. In Spain, despite its leading role in European clinical research, systematic analysis of inequalities in EPCT participation remains underexplored. This narrative review identifies and discusses key barriers affecting patient access to EPCTs in Spain, including strict eligibility criteria, socioeconomic and geographic barriers, differences in hospital resources, and biases among clinicians when selecting patients. Recommendations provided include revising eligibility criteria, improving training for healthcare professionals, enhancing referral networks, providing targeted education for patients, and addressing socioeconomic and geographic constraints. Addressing these barriers is essential to ensure equitable EPCT participation in Spain and to improve overall cancer outcomes.

Clinical & Translational Oncology
Hebron University (PS), Hospital General Universitario Gregorio Marañón (ES), Hospital Universitari i Politècnic La Fe (ES), Complejo Hospitalario Universitario de Santiago (ES), Hospital Universitario 12 De Octubre (ES), Vall d'Hebron Institut de Recerca (ES), Hospital Universitario Puerta de Hierro Majadahonda (ES), Hospital General Universitario de Elche (ES), Vall d'Hebron Hospital Universitari (ES), Hospital Universitario Fundación Jiménez Díaz (ES), Hospital Universitario Son Espases (ES), Hospital Clínico Universitario Virgen de la Victoria (ES), Instituto de Investigación Biomédica de Málaga (ES)
Sociedad Española de Oncología Médica
Openalex Percentile: Top 6%
Ethics in Clinical Research
DOIOpen Access PDFOpenAlex
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