Understanding the awareness-to-enrollment gap: An assessment of oncologist barriers in clinical trial accrual.

e13689 Background: Adult cancer clinical trial accrual remains critically low. Physician awareness is vital to increasing enrollment, yet trial discovery is often time consuming and disconnected from clinical workflows. As part of an NCI SBIR-funded project to integrate AI trial-matching into theMednet, a platform specifically designed to engage community-based oncologists, we sought to characterize oncologist trial searching behaviors and unmet needs. Methods: We surveyed oncologist users of theMednet.org to assess trial awareness, frequency of trial consideration during clinical care, enrollment activity and satisfaction with current trial discovery tools using a 5-point Likert scale. Participants will be resurveyed after 6 months of exposure to an AI platform that matches patient cases to appropriate clinical trials. Data were analyzed using descriptive statistics. Results: Respondents (n = 294) included medical (41%) radiation (46%), pediatric (6.5%) and gynecologic (5.4%) oncologists across academic (43%) and community (50%) settings. Seventy-seven percent of oncologists expressed confidence in discussing trials and 54% reported high awareness of clinical trials; 60% frequently consider trials during routine care. Consideration of trials strongly correlated with enrollment (Spearman’s ρ = 0.645, p < 0.001). Barriers emerged in trial discovery with only 42% reporting ability to identify trials efficiently. While a majority report using online tools (ClinicalTrials.gov, institutional databases) to search for trials, only 35% rate them as useful. Major barriers include finding appropriate trials (65%), logistical/practice barriers (64.3%) and time constraints (47.6%). Significant baseline disparities were observed between academic and community settings regarding awareness and enrollment, though readiness for AI-driven solutions was high across both groups (Table 1). Conclusions: Oncologists lack efficient discovery tools, particularly in community settings where 85% of patients receive care. Existing digital resources are widely used but poorly rated. Our data suggest the primary barrier is not a lack of interest, but a lack of effective tools. To bridge this gap, theMednet has developed an embedded AI trial matching platform designed to surface trials to physicians at the point of care. By leveraging theMednet’s extensive community reach, this intervention aims to reduce discovery barriers and democratize trial access for all patients. Future work will evaluate platform usability and impact on enrollment. Baseline trial behaviors by oncology practice setting. Academic (n=125) Community (n=148) p-value Trial Awareness (Mean Likert) 3.92 3.31 <.001 Trial Consideration (Mean Likert) 4.06 3.40 <.001 Zero Enrollments (Past 6 months) 16% 31.8% 0.001 Readiness for AI-Trial Matching Tool 90.4% 88.5% 0.82