Background: Clinical trials are routinely recommended as gold standard treatment options by most cancer guidelines. Ensuring equity of access to trials in regional and remote health services is an important quality indicator of cancer services delivery in regional Queensland. Thus, identification of current clinical trial capacity and unmet areas of need is important.

Methods: We performed an audit of medical oncology clinical trials activated at Sunshine Coast Hospital and Health Service (SCHHS) over a 10-year period. We reviewed the number of oncology clinical trials activated per year, by trial sponsor, by phase and tumour stream. A comparison of the growth in clinical trial numbers over years, along with corresponding principal investigators.

Results: A total of 56 trials recruiting 271 patients, were activated between 2014 and July 2024. Half were commercially sponsored (54%). Most trials were interventional studies (86%); 7% were related to biomarker discovery.

Phases 2, 3 and 4 trials comprised 34%, 52% and 2% respectively. No Phase 1 trial had been activated.

77% of trial patients (209/271) were enrolled into just three tumour streams – breast (14 trials), genitourinary (12 trials) and lung (13 trials). Patients with least access to trials included: central nervous system cancers (0 trial), gynaecological cancers (1 trial), upper gastrointestinal cancers and hepatobiliary cancers (2 trials each). Only 2 trials utilised the Teletrial model of care.

Conclusion: The total number of trials have greatly increased over the 10-year period, however, there is unequal access. Patients with breast, lung and genitourinary cancers had the widest access to clinical trials whilst those with gastrointestinal and rarer cancers were under-represented in trials. Only 2/56 trials have had a TeleTrial model of care. This audit highlights a significant area of need for patients.