BMS and IHI Launch a Three-Year Push to Broaden Cancer Trial Access
A new partnership between Bristol Myers Squibb and the Institute for Healthcare Improvement centers on one of oncology’s most persistent failures: too many eligible patients never reach a clinical trial. The Cancer Collective Action Collaborative will run for three years and bring together 24 teams across the healthcare ecosystem to confront the barriers that keep patients out of studies, especially in breast and lung cancer.
The initiative arrives against a backdrop of unequal cancer outcomes in the United States. Black women and men continue to face higher mortality rates from breast and lung cancer, and rural residence remains tied to higher cancer incidence and mortality because access to oncologists is thinner, screening is harder to obtain, and treatment often requires long travel distances. Those structural barriers do more than delay care; they also shrink the pool of patients who can even be considered for research participation.
This is not a recruitment problem alone. It is a systems problem.
Why Trial Participation Still Fails to Reach the Patients Who Need It Most
Clinical trials are often discussed as if the main obstacle is scientific complexity, but the practical barriers are usually much more basic: patients are never informed about a study, referral pathways are fragmented, community trust is weak, and the logistics of travel, time off work, and repeated visits can make participation impossible. For patients in rural communities, these obstacles stack on top of limited local specialty care. For patients in communities with a long history of medical exclusion, mistrust can be just as powerful a barrier as distance.
The collaborative is designed to tackle those failures at the point where they happen. Rather than focusing only on patient-facing education, the project aims to improve how health systems identify eligible patients, connect them to trial opportunities, and build enrollment pathways that are reliable instead of ad hoc. That matters because trial access depends on more than scientific eligibility; it depends on whether a healthcare system has the infrastructure to find the patient, explain the opportunity, and guide them through the process.
IHI has already released a four-step approach to help healthcare teams identify health disparities across settings. The new collaborative extends that equity work into oncology trial participation, with breast and lung cancer as the initial focus. Those diseases carry high public health burden, and disparities in mortality make them a logical starting point for a participation strategy aimed at underserved populations.
The Collaborative Model Targets Trust, Referrals, and Enrollment Infrastructure
The structure of the partnership suggests a broader view of trial enrollment than the usual sponsor site-selection model. Instead of simply opening more study sites, the collaborative will work on the mechanisms that determine whether patients ever arrive at those sites. That includes strengthening patient and community engagement, building trust, equipping care teams and community partners, and creating more inclusive pathways to enrollment.
In practice, that means the work will need to happen across primary care, oncology, community organizations, and health system leadership. A patient may first encounter cancer care in a setting far removed from the trial sponsor, and if the handoff fails there, the protocol never enters the conversation. Reliable enrollment pathways can reduce that gap, but only if clinicians have the tools and incentives to identify eligible patients early and refer them consistently.
Shannon Stephens, IHI’s interim vice president of health equity, framed the issue as both an ethical obligation and an achievable operational task. Her comments point to a core truth in oncology access: patient experience and clinical expertise are both necessary, but neither is enough on its own. Trial participation improves when lived experience informs design, coordination is deliberate, and local partners are treated as part of the research ecosystem rather than as peripheral observers.
Breast and Lung Cancer Carry the Heaviest Equity Burden
The choice to begin with breast and lung cancer is clinically and socially consequential. These are among the most visible malignancies in the public discourse, yet disparities remain stubbornly present in both outcomes and access to innovation. Higher mortality in Black women with breast cancer and Black men with lung cancer reflects more than biological risk. It reflects delayed diagnosis, uneven screening access, differential referral patterns, and historical gaps in treatment access that continue to shape real-world survival.
Clinical trial access follows the same fault lines. If screening is delayed, diagnosis arrives later. If specialty care is concentrated in urban centers, enrollment opportunities become geographically skewed. If a patient has to travel long distances for each trial visit, participation may become unrealistic even when eligibility is clear. The result is a research population that can drift away from the population most affected by disease burden.
The collaborative is trying to interrupt that cycle by making enrollment less dependent on geography, chance, or individual clinician initiative. In oncology, access inequity can quietly distort the evidence base itself. When participation is concentrated among patients with easier access to academic centers, the resulting data may reflect a narrower slice of the population than the disease actually affects.
Corporate and Nonprofit Alignment Around a Shared Access Goal
BMS’s participation signals that trial access is being treated as part of innovation strategy, not as a separate social program. Andrew Whitehead, vice president and head of population health at BMS, said the company believes every person should have the opportunity to benefit from its medicines and innovation, regardless of who they are, where they live, or what they have. In oncology, that principle has practical weight. A therapy cannot deliver equitable benefit if the trial pathway itself excludes the people most likely to need it.
The partnership also reflects a growing recognition that health equity initiatives need operational partners who can move across the healthcare system rather than stay confined to one institution. IHI brings a systems-improvement lens, while BMS brings sponsor expertise and the ability to influence trial access discussions at scale. The 24-team structure suggests an attempt to distribute the work across multiple points of care instead of relying on a single center or pilot project to carry the burden alone.
The initiative’s success will depend on whether those teams can make enrollment pathways durable enough to outlast the grant cycle and visible enough to change routine care. Rural patients, patients from historically marginalized communities, and patients with limited specialty access do not benefit from abstract commitments. They benefit when a clinician identifies a study, a referral lands correctly, transportation and communication barriers are addressed, and the enrollment process is simple enough to complete.
Three years is a meaningful runway, but the real test will be whether the collaborative can turn equity language into repeatable clinical workflows. The article does not provide enrollment targets, site counts, or outcome measures, so the most important unanswered question remains whether the program can produce measurable gains in trial participation among the populations it is designed to reach.