Growing evidence has demonstrated significant, persistent, and widespread disparities in cancer clinical trial enrollment across myriad disease sites and target populations. Although mechanisms underlying such disparities are complex and multifactorial, clinical trial eligibility criteria may serve as a key structural barrier to equitable and diverse trial enrollment. In this review, we provide an overview of the data describing historical and current disparities in cancer clinical trial enrollment and subsequently describe several patient-, institution-, and trial-related factors which appear to be key drivers of enrollment inequity, with specific discussion regarding the impact of eligibility criteria. We further describe the landscape of ongoing professional efforts aimed at eliminating clinical trial disparities through various medical, professional, and advocacy groups. The review concludes with a practical discussion of how modernization of eligibility criteria in clinical trials may decrease or eliminate trial disparities, including specific actionable recommendations aimed at improving the quality of future eligibility criteria.

越来越多的证据表明，各种疾病地点和目标人群的癌症临床试验注册情况存在显着、持续和广泛的差异。尽管造成这种差异的机制是复杂且多因素的，但临床试验资格标准可能成为公平和多样化试验招募的关键结构性障碍。在这篇综述中，我们概述了描述癌症临床试验注册的历史和当前差异的数据，随后描述了几个患者、机构和试验相关因素，这些因素似乎是注册不平等的关键驱动因素，并具体讨论了资格标准的影响。我们进一步描述了旨在通过各种医疗、专业和倡导团体消除临床试验差异的持续专业努力的情况。该综述最后对临床试验中资格标准的现代化如何减少或消除试验差异进行了实际讨论，包括旨在提高未来资格标准质量的具体可行建议。