J&J Survey Of Oncologists Reveals Challenges With Awareness & Access
A conversation with Biljana Naumovic, worldwide vice president, global commercial strategy, oncology, Johnson & Johnson
Oncology research is complicated, it’s moving incredibly fast, and Biljana Naumovic knows it.
“Oncologists are doing an amazing job navigating the pace of change, placing patients in clinical trials, and making sure their patients receive the best care each and every day. And they’re doing all of this while living in a world where cancer treatments are advancing at a never-before-seen pace,” she prefaced, before discussing Johnson & Johnson’s Oncology Care Index.
The index reveals some of the challenges oncologists face, and J&J intends to help solve them, Naumovic explains.
Clinical Leader: The Oncology Care Index reports that only 27% of respondents said their practices offer a robust range of clinical trial options, while most offer limited (52%) or none (18%). What was your reaction to this finding?
Biljana Naumovic: This finding confirms that our decades-long dependence on academic institutions is a harsh reality we must address: Access to clinical trials remains uneven across community and academic centers. That matters because clinical trials are often the path to tomorrow’s familiarity with and fast adoption of treatments. There’s ample work to be done, and we are actively simplifying participation and bringing research opportunities into the communities where patients already receive care. In order to do it better and faster, we hope to partner with community oncologists to find ways to bring more trials to community settings wherever possible.
What are some reasons that less than a third of practices have robust research offerings? And what is considered to be robust?
A robust offering means a diverse set of trials across tumor types, clear operational support, and an infrastructure to enroll patients efficiently. While the Oncology Care Index didn’t ask specifically about the reasons why the respondents didn’t feel they had robust research offerings at their practice, there are a few reasons I can think of. The burden of trial start-up, training, and compliance is real, and too often it falls on physicians who are already stretched thin. Additionally, the study setup, such as the inclusion and exclusion criteria, lab, or process requirements, may make it infeasible for community oncologists to participate. Lastly, we intend to remove barriers to participation, as well as engage community oncology centers in the study planning, which is necessary to change the way we did things in the past.
Knowing now that the majority of practices have fledgling research options, what is J&J doing or planning to help drive physician participation in clinical trials?
It’s less about driving physician participation in clinical trials and more about giving healthcare professionals better tools to make it easier for them to match the right patients to the right trials. And we own a part of this.
Some of the focus areas include simplifying activation processes, providing hands-on support, and designing trials that work in real-world community settings. We’re also using data and technology to better match trials to the right sites, so physicians feel more confident and capable of participating. For example, our AI-enabled platform Trials360.ai leverages AI/ML to identify and prioritize clinical trial sites with a high probability of enrolling patients. There’s more work to be done, but these are some steps we’re taking to improve access to clinical trials.
Additionally, 91% of HCPs said their patients’ proximity to care affects their treatment decision. How does proximity impact a care decision or a decision to recommend a clinical trial?
Proximity shapes care in real ways. If a trial or treatment requires frequent travel to an urban academic center, it may be off the table for many patients. That’s especially true for those juggling jobs, caregiving, or living in rural or underserved areas. It’s one of the reasons we’re investing in bringing trials to community sites and supporting models like satellite sites that reduce patient travel and disruption.
What might be done to positively influence a physician to recommend clinical trials, in general?
Again, I’m not sure we should be putting everything on the physicians here, because in my interactions with HCPs, they are eager and willing to recommend a trial. There are other things at play: In the Oncology Care Index, healthcare professionals cited geographic barriers, lack of transportation, and childcare as the main barriers to patient participation in a clinical trial. So, it’s not that physicians aren’t recommending the trials, it’s that the trials are not meeting the needs of the patients they’re treating. That’s where we need to lean in. Trials must be built with the realities of community practice in mind wherever possible.
The index also reveals that “3 out of 4 oncologists find the pace of new treatment development overwhelming.” Why do you think that is? Are there challenges with communicating new therapies to doctors?
I honestly think it’s the sheer volume of innovation. In 2024, oncology treatments were approved in the U.S. for more than 50 indications, including 11 first-in-class therapeutics.1 That is welcome innovation, but it’s happening faster than ever. When you add complex and evolving guidelines, payer requirements, and administrative burdens, it’s a lot for any healthcare professional to navigate. This is why we launched the survey; we wanted to see what challenges healthcare professionals face and how we can drive solutions. Because we know the pace of innovation isn’t changing anytime soon, we have to offer support to make sure the latest breakthroughs reach the patients who need them.
“73% of surveyed HCPs say there’s a gap between the availability of new/cutting-edge treatments and their successful implementation in clinical practice.” How might increased clinical trial awareness and/or participation among physicians play a role in improving new treatment awareness and implementation? Is there a connection?
Physicians who participate in clinical trials often gain early experience with new therapies and become familiar with how to use them in practice. Having that direct firsthand experience allows physicians to put all available options in a better context and learn early on which therapy is the best fit for a particular patient.]
J&J is leveraging AI/machine learning to identify and prioritize clinical trial sites with a high probability of enrolling patients. Can you walk us through the preparations for this? What information or data is needed to begin an AI-assisted process?
We use numerous data sources to prioritize clinical trial sites. For a given disease, this includes ongoing and historic trial data, real-world data that is linked to medical institutions and local geography, census data, and data from organizations like the CDC, as well as other situationally appropriate sources. Algorithms are designed to uniquely combine these data sources to produce a human-defined optimal site profile. Collectively, these data sources assess the appropriateness of local treatment patterns, patient volumes, competing trials, and whether the sites have a representative population suitable for the study. The importance of these factors can vary from study to study; hence, each trial has its own parameters.
Once the data is used to inform the AI tool and outputs are generated, how do you vet and finalize the recommendations?
There is a human at the end of each process, where experienced trial scientists make the final calls. This is often an iterative process where site interactions, such as qualification assessments and additional bespoke data-driven insights, can optimize decision-making. Final decisions for a given trial uniquely weight AI-driven recommendations with human factors that currently cannot be encoded in algorithms. Trial site lists are then used to model the trial itself, which can predict the enrollment timelines and readout of the trial. These models can further inform trial plans.
What are some other “next steps” J&J plans to pursue on the heels of this index’s findings?
We see the Oncology Care Index as a catalyst, not just for what we aim to do better but also for broader conversation and work throughout the healthcare ecosystem to close these gaps. For J&J specifically, it’s guiding where we invest, how we engage physicians, and how we evolve our trials. We’re doubling down on expanding community access to research, simplifying how physicians learn about and implement new treatments, and using technology more strategically. Most importantly, we’re listening. The findings give us direction, but the day-to-day experiences of community oncologists will continue to shape our response, because the best way to bring our innovative treatments to patients everywhere across the U.S. is through community oncology.
References:
- Novel drug approvals for 2024. U.S. Food and Drug Administration (FDA). https://www.fda.gov/drugs/novel-drug-approvals-fda/novel-drug-approvals-2024. January 15, 2025. Accessed February 14, 2025.
About The Expert:
Biljana Naumovic is president, U.S. solid tumor, and a member of the Johnson & Johnson Innovative Medicine North America Leadership Team. In this role, she leads one of the company’s fastest-growing therapeutic areas and advances the organization’s solid tumor portfolio and pipeline. Biljana is a passionate leader with significant global and regional leadership experience across therapeutic areas. She is a physician by training and leverages her medical expertise and commitment to talent development to drive better outcomes for patients.