Realizing Equitable Precision Oncology via Remote Participation: Japan's First Fully Decentralized Trial (WJOG15221M).

WJOG15221M is Japan's first fully remote, investigator-initiated oncology trial, successfully enrolling 28 patients-36% remotely-by integrating trial access into the national CGP program and leveraging existing healthcare infrastructure without new digital tools. Targeting rare ALK fusion-positive tumors, the trial demonstrated that decentralized models can improve equity, efficiency, and continuity of care, offering a scalable path for future precision oncology trials.