Advanced Practice Provider-Led Trials in Radiation Oncology: Are We Missing the Opportunity?

Advanced practice providers (APPs) are integral members of radiation oncology care teams yet remain underrepresented in clinical research leadership. This article explores the barriers, opportunities, and strategic pathways for expanding APP-led research, particularly in patient-reported outcomes (PROs) and health services research. Despite APPs' daily proximity to symptom management, patient communication, and care delivery workflows, systemic challenges such as limited protected time, inconsistent credentialing policies, and lack of mentorship inhibit broader scholarly engagement. National initiatives like The Patient-Reported Outcomes Tools: Engaging Users and Stakeholders (PROTEUS) Consortium offer accessible tools and funding opportunities to promote rigorous, patient-centered PRO integration in trials and clinical practice. By aligning APP strengths with national research priorities and supporting protected time, mentorship, and clearer principal investigator pathways, institutions can unlock a critical avenue for innovation. Advancing APP-led research is not just an investment in professional development but also a strategic imperative to ensure radiation oncology research is as patient-centered, inclusive, and impactful as the care it aims to improve.