Finally, instead of excluding patients on the basis of comorbidities such as malnutrition or diabetes, these medical issues could be addressed in combination with experimental therapy within the context of a clinical trial. For example, patients with pancreatic cancer and poorly controlled diabetes or malnutrition could be randomly assigned to the primary therapeutic intervention, while also receiving coordinated care within the clinical trial to address blood glucose control or nutrition. This type of patient-centric trial design could not only increase eligibility but also improve patient adherence to study protocols, reduce therapeutic toxicity, and enhance eligibility for future treatments. Ultimately, with an inclusive and intentional approach, we can more effectively study whether novel therapies will benefit the diverse population of patients with cancer in need of our care.

These findings are not surprising given generalized lack of clinical trial availability for early-stage patients and second primary cancer being a common exclusion criterion.

anticipated noncompliance,

With traditional criteria, Black patients were more likely to be ineligible for participation compared with White patients (42.4% v 33.2%, P = .023; Fig 2). Revised criteria (Table 1) included removing historical, controllable, or manageable medical conditions including HIV, hepatitis C virus, hepatitis B virus, diabetes mellitus, previous cancer, and coronary stenting. After applying revised criteria, there was no longer any difference in ineligibility rates for Black or White patients (26.8% v 24.8%, P = .581; Fig 2).