Optimizing Recruitment for Breast Cancer Clinical Trials

Welcome to the October 2026 edition of Citeline’s Patient Recruitment Pulse. In this monthly blog, we discuss the trends shaping today’s patient recruitment landscape. This month, we focus on optimizing patient recruitment for the complex breast cancer clinical trials landscape.

Challenges with breast cancer trial participation include overwhelmed patients, unclear communication, and seeking trusted information sources. Discover ways to combat these recruitment obstacles.

Clinical trials are essential for advancing cancer care, yet research indicates 7.1% patients with cancer participates in clinical trials because of obstacles at the system, trial, provider, and patient level.

When looking at breast cancer in particular, studies report clinical trial participation rates ranging from 5% to 25%. While the high end of this range indicates some positive progress in breast cancer recruitment, the low end indicates there are still many challenges for sponsors looking to fill breast cancer studies.

Overwhelmed patients, unclear communication

Breast cancer treatment usually begins shortly after diagnosis, which leaves a relatively small window of time in which these patients can be recruited for a clinical trial. Since recruitment often occurs early in the treatment process, it can be overwhelming for patients who are still adjusting to their diagnosis.

In a University of Alabama at Birmingham-based study exploring the perspectives of breast cancer patients on clinical trial participation, 38% reported being recruited early on in their breast cancer diagnosis, often during their initial physician visit or chemotherapy appointments. Many found this to be an off-putting practice, with one patient saying, “… offering clinical trials at the beginning of a chemo treatment … I just thought the timing was inappropriate.”

Communication as to the logistics, risks, side effects, and expected outcomes is sometimes unclear and lacking information pertinent to patients making a decision about participation. In the University of Alabama at Birmingham study, 90% of participants stressed the need for better communication during the recruitment process. While some did experience good communication, others found it lacking in their recruitment meetings. Most patients (81%) said they needed thorough, clear explanations about the trial’s logistics, side effects, goals and expected outcomes, benefits, and risks, to make informed decisions.

Then there’s the matter of getting into the trial. Criteria for breast cancer trials can be complex, so not all patients who want to participate qualify for a trial. For example, some older patients who do agree to participate don’t qualify for the trial based on age-associated pre-existing medical conditions, with one study noting the average geriatric cancer population has three of these co-morbidities.

Finding sources they can trust

Patients often prefer to hear about clinical trials from their doctors. One study found 76% of participants expected physicians to let them know about any appropriate clinical trials. In the University of Alabama at Birmingham study, many patients said they wanted their physicians to be the ones to recruit them to clinical trials, citing trust and continuity of care.

Unfortunately for patients, physicians often have a difficult time finding information about clinical trials, and sometimes they don’t trust the information they receive. Responses from physicians responding to a Citeline survey paint a clinical trial information landscape that’s confusing, incomplete, and difficult to navigate. They also express lack of trust in many information sources, with pharmaceutical company websites among the least recommended.

It’s important to make reliable clinical trial information accessible to physicians, because patients who hear about clinical trials from other media sources may not find the information trustworthy and may be more reluctant to participate. The one exception appears to be social media. Some participants in the University of Alabama at Birmingham study specifically cited social media as a “great” source of clinical trial information, indicating it may be more trustworthy than other unsolicited approaches.

Facebook was singled out because of its plethora of support groups, with one participant suggesting researchers and/or physicians join these online groups. The patient’s reasoning was that the presence of physicians or medical experts on these forums could offer a valuable opportunity to reach patients and increase health literacy about clinical trials.

Ways to optimize patient recruitment

All these factors point to several ways to sharpen patient recruitment for breast cancer trials. Here are some tactics for sponsors to consider:

• Give patients as much time as possible to consider whether to participate in the trial. While it’s true that the window for breast cancer clinical trial participation can be small, try to utilize as much of that window as possible so that the patient doesn’t feel pressured or overwhelmed.
• Involve the treating physician in the communication process. Patients trust their doctors and want to hear about clinical trials from them first and foremost. Make sure the physician knows about the trial and has all the information needed to clearly and thoroughly explain the trial to the patient.
• Use social media, particularly Facebook, to inform patients about clinical trials that are actively recruiting. Patients are already used to seeing recruitment messages in online channels, so having a researcher or physician involved in the trial join an online breast cancer support group can be a good way to reach out to patients who may be a good fit for a trial. Of course, the researcher or physician needs to be up front about their reason for joining and prepared to answer questions about the trial with clarity and candor.