Highlights from the Advanced Practice Practitioner (APP) Symposium at the NRG Oncology 2025 Summer Meeting

11/12/2025

The Advanced Practice Practitioner (APP) Symposium at the 2025 NRG Oncology Summer Meeting highlighted the evolving and increasingly vital role of advanced practice professionals in cancer clinical research. As of the most recent nationwide data (2018), there are an estimated 5,000 to 7,000 Advanced Practice Providers (APPs) working in oncology in the United States. One Medicare study analyzing SEER data on older adults with cancer found that APPs (NPs and PAs) comprised ~56.2% of ambulatory oncology providers, compared to 27.7% physicians, and another study showed that APPs provide significantly more rural cancer care than oncologists.  Inclusion of APPs in NCTN cooperative groups would open a vast untapped resource for clinical trial participation.

Over the past several years, APP participation within the National Cancer Institute (NCI) network has expanded steadily. Early surveys from 2019–2020 revealed strong interest among APPs in research involvement but also identified barriers such as limited training, lack of mentorship, and policy restrictions on trial participation. Since then, coordinated efforts across NRG Oncology, SWOG, and ECOG-ACRIN have begun addressing these gaps through education, policy reform, and the creation of APP-focused working groups.

Recent NCI policy updates have formally recognized APPs as key contributors to clinical trials. Under current guidelines, qualified APPs may independently enroll patients, write study-related orders, and serve as investigators without physician co-signature. Data presented at the symposium suggest these changes are having a meaningful impact. At some NCORP sites, APPs have accounted for a substantial proportion of patient accruals, demonstrating both the capacity and readiness of the APP workforce to support trial activity.

The symposium also emphasized that greater APP participation can improve operational efficiency, patient access, and research continuity, while offering professional growth and engagement opportunities for APPs themselves. However, participants noted that challenges remain, including ensuring equitable access to training resources, expanding mentorship, and increasing representation of APPs in protocol design and leadership roles.

NRG Oncology is exploring the formation of an APP subcommittee to continue advancing these priorities and looking for more APPs to join this effort. The subcommittee’s goals include enhancing educational opportunities, supporting research skill development, and ensuring that APP perspectives are consistently represented within cooperative group studies. Please join us for the APP breakout session held during the NCORP Bootcamp on January 22, 2026, 12:00 – 1:45pm PT. Register here.

As oncology research continues to evolve, integrating APPs across all stages of trial development and conduct represents a practical and evidence-based approach to improving the reach and quality of cancer research nationwide.