Telemedicine as a Gateway to Early-Phase Oncology Trials: Lessons from 14,000 Patients and Future Directions for Global Access and Equity

Authors

Carlos Torrado
Clark R Andersen
Lei Kang
Amanda L Brink
Taiwo Adesoye
Hung Le
Clover J Patterson
Anna Poullard
Jessica A Osburn
Harold N Tan
Mohamed A Gouda
Sheena Charles
Gabriele E Urschel
Tin-Yun Tang
David S Hong
Stephane Champiat
Aung Naing
Apostolia M Tsimberidou
Ecaterina E Dumbrava
Sarina A Piha-Paul
Jordi Rodon
Timothy A Yap
Paula R Pohlmann
Funda Meric-Bernstam
Siqing Fu

Language

English

Publication Date

3-13-2026

Journal

The Oncologist

DOI

10.1093/oncolo/oyag075

PMID

41830429

Abstract

Background: Telemedicine 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 methods: We 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.

Results: Of 14,085 patients, 7,247 were evaluated post-pandemic, with 36% (n = 2,616) 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 = 0.0002) and had higher enrollment (54.2% vs. 39.4%; p < 0.0001) 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 = 0.0001). After the PHE ended, telemedicine increased among Texas patients (48%→56%) but declined among out-of-state patients (26%→12%).

Conclusions: Telemedicine 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.

Keywords

Access to oncology care, Early-phase clinical trials, Enrollment barriers, Patient recruitment, Telemedicine

Published Open-Access

yes

Recommended Citation

Torrado, Carlos; Andersen, Clark R; Kang, Lei; et al., "Telemedicine as a Gateway to Early-Phase Oncology Trials: Lessons from 14,000 Patients and Future Directions for Global Access and Equity" (2026). Faculty, Staff and Student Publications. 6323.
https://digitalcommons.library.tmc.edu/uthgsbs_docs/6323