# A mandatory trial line in every tumour board recommendation

Source: https://onco.cc/ideas/idea-tr1-tumour-board-trial-line-item/  
OnCo record `idea-tr1-tumour-board-trial-line-item` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Every time a team of specialists meets to plan a patient's treatment, they would have to record whether a trial exists for that patient and, if so, why it was or was not offered.

## Summary

Multidisciplinary tumour boards and molecular tumour boards add a required structured field to their recommendation: matched trials considered (with identifiers), offered yes/no, and reason if not. A trial coordinator pre-populates the field from a matching tool before the meeting. The field is auditable and the offer rate reported quarterly by service.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Making trial consideration a documented step raises the trial offer rate from the typical single digits to over 20 percent of board-discussed patients within a year, and enrolment rises in proportion.
- Rationale: Checklists change behaviour where the omission is habitual rather than deliberate. Surgical safety checklists and the 'sepsis six' work through the same mechanism. Tumour boards already have the structure; only the field is missing.
- Proposed test: Before-after with contemporaneous control services in two cancer centres; outcome is documented trial offers and enrolments per 100 board discussions.
- Maturity: speculative
- Actor: clinic

## Sources

- Bottleneck evidence (Trials enrol too few, too slowly): Unger et al., Systematic review of barriers to cancer trial participation (JNCI 2019): https://doi.org/10.1093/jnci/djy221

## Connected records

- technologies: [AI trial matching & clinical decision support](https://onco.cc/technologies/ai-trial-matching/)
- institutions: [Gustave Roussy](https://onco.cc/institutions/gustave-roussy/), [Memorial Sloan Kettering Cancer Center](https://onco.cc/institutions/mskcc/), [The Royal Marsden](https://onco.cc/institutions/royal-marsden/)
- bottlenecks: [Trials enrol too few, too slowly](https://onco.cc/bottlenecks/b-trial-enrolment/)

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