Commercial CAR-T vs Clinical Trials in China: What International Patients Need to Know
- MedBridgeNZ
- 6 days ago
- 16 min read
By MedBridgeNZ | Last updated: 11 August 2026
International patients researching commercial CAR-T vs clinical trials in China are often presented with two apparently simple choices: pay for a commercially available product or try to enter a clinical trial. The real distinction is more complex. An approved product is approved only for specified indications and still requires hospital assessment. A clinical trial offers access under a research protocol, not a guaranteed treatment place, and the word “trial” does not by itself explain the regulatory route, phase, eligibility rules, costs or whether an overseas patient can participate.
Evidence scope: This article explains general regulatory, administrative and cross-border access differences using current Chinese government information, public trial registries and patient-participation guidance. It does not reproduce any hospital’s private protocol, identify a suitable product for an individual or predict trial acceptance. Commercial availability, approved indications and recruitment status can change after the evidence-check date.
Editorial method: This comparison is based on official Chinese regulatory sources, public trial-participation guidance and recurring cross-border administrative questions. It does not reproduce private patient communications or identify any patient.
Key Takeaways
Commercial CAR-T uses a product approved by China’s National Medical Products Administration (NMPA), but approval applies to the registered product and indication - not to CAR-T as a general treatment for every cancer.
A CAR-T clinical trial uses an investigational product, indication, combination, dose or strategy under a defined protocol. Entry requires formal screening and informed consent. A registry entry marked “Recruiting” is only a lead; it does not confirm that a particular site has a place or accepts international patients.
A trial should not be described simply as “free CAR-T.” Chinese rules prohibit charging participants fees related to the applicable clinical trial or biomedical new-technology research, but routine care, non-study treatment, travel, accommodation and other items may still require written clarification.
Commercial access is not automatically immediate, and trial access is not automatically slower. Disease control, washout and recovery, screening, apheresis, manufacturing capacity, admission slots and clinical stability can alter either pathway.
MedBridgeNZ can compile and translate records, request written pathway and cost clarification, facilitate institutional communication and coordinate travel after an institutional response. It does not select treatment, determine eligibility or enrol a patient in a trial.
Quick Answer
Commercial CAR-T and clinical-trial CAR-T are different access frameworks. In a commercial pathway, a hospital assesses whether an NMPA-approved product can be considered within its registered indication and current institutional process. Payment responsibility and any insurance reimbursement must be confirmed through a written, itemised estimate.
In a clinical trial, the research team applies a specific protocol. The consent form and site budget should state which research-related items are funded and which routine-care, non-study or travel costs remain payable. Record submission, a remote pre-screen and a “Recruiting” registry status are not enrolment.
Neither pathway is inherently better. The relevant question is which pathway, if any, the responsible specialists consider medically and operationally feasible for the documented diagnosis, target, treatment history, current condition and timeframe.
Do not stop, postpone or change chemotherapy, corticosteroids or another treatment while waiting for an overseas trial or commercial review. Treatment timing must be coordinated by the local treating oncologist and the receiving CAR-T team.
Commercial CAR-T vs Clinical Trials in China: Side-by-Side Comparison
Question | Commercial CAR-T | CAR-T Clinical Trial or Clinical Research |
Regulatory position | Uses an NMPA-approved product. Approval is tied to the registered indication and current product information. | Uses an investigational product, indication, combination, process or strategy under an approved or filed research protocol. |
Primary purpose | Clinical treatment using an approved product. | Generation of evidence about safety, dose, activity, efficacy or a new use. Participant benefit may occur but is not guaranteed. |
Eligibility source | Product information plus the hospital’s clinical and operational assessment. | Protocol-specific inclusion and exclusion criteria plus site screening and investigator judgement. |
Product certainty | The intended commercial product can usually be named before treatment, subject to hospital acceptance and availability. | The product or strategy is identified in the protocol, but dose cohort, randomisation, treatment arm or manufacturing feasibility may affect what the participant receives. |
Access certainty | A positive remote review still does not guarantee apheresis, manufacturing, admission or infusion. | A preliminary match still does not guarantee consent, on-site eligibility, manufacturing or treatment. |
Timing | May have a clearer payment and scheduling pathway, but collection, manufacturing, recovery and bed capacity still matter. | Depends on active recruitment, cohort availability, screening, protocol windows, sponsor/site approval and manufacturing capacity. |
Costs | Payment responsibility and any insurance reimbursement must be confirmed in a written, itemised estimate. The product price is not the complete episode-of-care cost. | Applicable Chinese rules prohibit charging participants fees related to the covered trial or clinical research, but the consent form and site budget must define research-related, routine-care and non-study expenses. |
Evidence maturity | Supported by the evidence reviewed for regulatory approval and post-marketing use in the approved indication. | Evidence maturity depends on the phase and design. Early-phase research may focus mainly on safety and dose. |
Ability to choose | The treating team discusses approved options that are available and clinically relevant; patient consent remains required. | Choice may be constrained by cohort, randomisation, protocol design or available slots. Some trials are single-arm; others are comparative. |
International access | Depends on whether the hospital accepts the case and can support an overseas patient through the complete pathway. | Depends on the protocol and the individual site’s current willingness and capacity to enrol an overseas participant. Registry nationality fields alone are not enough. |
Follow-up | Product and hospital follow-up requirements apply, including long-term safety monitoring where required. | Protocol-defined follow-up may be extensive and may require repeated visits, tests and data collection after the patient returns home. |
What Counts as “Commercial CAR-T” in China?
Commercial CAR-T means the intended cellular product has received NMPA marketing approval and is being considered within an approved clinical framework. This does not mean that any patient with the same broad cancer name can receive it.
The receiving hospital still needs to confirm matters such as:
the exact diagnosis, disease subtype, target antigen and required biomarker;
the approved line of therapy, prior treatments, age and other label-related conditions;
current disease status, organ function, infection risk and performance status;
whether T-cell collection and manufacturing appear feasible after recent treatment;
current product, manufacturing, admission and monitoring capacity; and
whether the patient can complete the required follow-up safely.
Approval therefore reduces one type of uncertainty - the product is no longer investigational for its registered indication - but it does not remove patient-level or hospital-level assessment.
A 2026 Solid-Tumor CAR-T Update That Changes the Comparison
On 22 June 2026, the NMPA approved satricabtagene autoleucel injection for a specific solid-tumor indication: CLDN18.2-positive, HER2-negative advanced gastric or gastroesophageal-junction adenocarcinoma after failure of at least two prior lines of therapy. See the NMPA approval notice.
This is an important correction to older summaries that describe all solid-tumor CAR-T treatment as investigational. As of the evidence-check date, the more accurate statement is:
selected blood-cancer indications have approved commercial CD19- or BCMA-directed CAR-T options in China, including a BCMA-directed approval announced by the NMPA;
one defined CLDN18.2-positive gastric/gastroesophageal-junction indication now has an approved commercial CAR-T option; and
most other solid-tumor CAR-T targets, cancer types and treatment settings remain investigational.
An approval for one biomarker-defined indication must not be presented as approval for gastric cancer generally, for all CLDN18.2-positive cancers or for other solid tumors.
For a broader overview of hospital pathways, practical access and cost planning, read our guide to CAR-T therapy in China for international patients.
What Counts as a CAR-T Clinical Trial in China?
The phrase “clinical trial” is often used loosely in cross-border enquiries. Before comparing it with commercial treatment, ask the institution to identify the exact research route.
Pathway label | What to request before relying on it |
NMPA-regulated drug clinical trial | Chinese CTR registration number, protocol title, sponsor, phase, participating site, current site status, investigator contact and informed-consent version. An NCT number may also exist for internationally registered studies. |
Investigator-initiated clinical research or biomedical new-technology research, depending on legal classification | Official project title, responsible institution, principal investigator, ethics approval, required filing or public record under the applicable framework, participant-cost policy and injury-protection arrangements. |
Approved commercial use | Generic product name, NMPA approval information, registered indication, current product information, treating hospital, written acceptance step and itemised estimate. |
China’s NMPA requires drug trials conducted in China to be registered and publicly disclosed through the official Drug Clinical Trial Registration process. Separately, the State Council’s Regulation on the Administration of Clinical Research and Clinical Translation of New Biomedical Technologies took effect on 1 May 2026. Depending on how a hospital CAR-T research programme is structured, different regulatory and filing requirements may apply.
This distinction matters because a hospital-developed research programme is not automatically equivalent to an NMPA-regulated drug clinical trial, and neither pathway is evidence of commercial approval. The research institution should state the legal and regulatory pathway in writing.
What Does the Trial Phase Tell You?
Phase or design | Main question commonly being studied | What an international patient should clarify |
Early phase / Phase I | Safety, dose, feasibility and early biological or clinical activity | Dose cohort, unknown risks, manufacturing failure rules, admission intensity and whether direct benefit is expected or uncertain. |
Phase II | Activity or efficacy in a defined population, with continued safety assessment | Required biomarker threshold, prior-line rules, response endpoint, cohort availability and whether the study is single-arm or comparative. |
Phase III or confirmatory study | Comparison with another treatment or strategy in a larger population | Randomisation, control treatment, crossover rules, treatment allocation and which routine-care costs apply. |
Investigator-initiated research | Question and design vary substantially by protocol | Institutional governance, filing, ethics approval, funding, participant charges, adverse-event care and long-term follow-up. |
Phase does not rank a treatment from “bad” to “good.” It describes the research question and evidence stage. The informed-consent process should explain foreseeable risks, alternatives, procedures, costs, injury arrangements, voluntary participation and the right to withdraw.
Does “Recruiting” Mean a Trial Place Is Available?
No. A public registry status is a starting point for verification. The overall study may be recruiting while:
the relevant Chinese site has not opened;
the site has filled its current cohort;
recruitment is paused during a safety or protocol review;
the next manufacturing or bed slot is not available;
the site does not have an international-patient intake pathway;
the patient’s disease subtype, biomarker result or prior treatment does not match;
an updated protocol has changed the criteria; or
the public record has not yet reflected a recent site-level change.
ClinicalTrials.gov guidance advises potential participants to review the eligibility, contacts and locations in the record and contact the study team. For a China-based drug trial, the Chinese CTR record should also be checked. Neither registry performs the patient’s screening.
For an international patient, written confirmation should answer four separate questions:
Is this exact site currently screening the relevant cohort?
Will the site consider a person who lives outside China?
Can records be pre-screened before travel, and what remains to be repeated in China?
What event would justify travel: document receipt, a remote pre-screen, a formal screening appointment or confirmed enrolment?
A “potential match” is not a treatment reservation.
How Is Trial Eligibility Different from Commercial Eligibility?
Both pathways assess safety and clinical relevance, but a trial adds research-specific rules that may exclude someone who could otherwise receive clinical care. Common protocol questions may include:
exact pathology, disease classification and measurable-disease requirements;
antigen or biomarker method, threshold and testing laboratory;
prior therapies and whether earlier CAR-T, transplant, immunotherapy or target-directed treatment is permitted;
treatment-specific washout periods, blood counts and lymphocyte recovery;
organ function, infection risk, immunosuppression and performance status;
ability to tolerate leukapheresis, lymphodepletion and inpatient monitoring;
prohibited medicines, planned treatment changes, pregnancy and contraception requirements; and
follow-up feasibility and availability of required tissue, slides, DICOM imaging or fresh testing.
A patient can look eligible from a diagnosis summary and fail after pathology review, laboratory testing, imaging, infection screening or a change in condition. Conversely, recent chemotherapy may require a timing review rather than create permanent exclusion. Only the receiving commercial team or trial investigator can apply the relevant rules.
Patients preparing for an initial institutional review can use our CAR-T pre-screening medical records checklist for China to organise pathology, imaging, biomarkers, treatment dates and recent results.
For a closer explanation of how recent treatment can affect timing questions, see our guide to CAR-T washout periods, chemotherapy and apheresis timing.
Is a CAR-T Clinical Trial in China Free?
“Free CAR-T” is an unsafe shorthand. China’s current Drug Administration Law implementation rules state that a drug-trial sponsor and trial institution must not charge participants fees related to the clinical trial. State Council Order No. 818 similarly states that sponsors and institutions may not charge participants fees related to biomedical new-technology clinical research.
Those protections are important, but international patients still need a written, itemised explanation. The boundary between research-related costs and other costs can affect the real budget.
Costs commonly requiring written clarification
screening performed before formal consent or outside the research site;
pathology review, biomarker retesting or shipment of physical slides;
standard-of-care treatment, bridging therapy or supportive care not required solely by the protocol;
routine hospital care, non-study medicines and treatment of the underlying disease;
management of complications that the institution determines are not research-related;
care after screen failure, withdrawal, progression or trial closure;
follow-up performed in the patient’s home country;
medical-record translation and interpretation;
visa, flights, local transport, accommodation, meals and caregiver expenses; and
emergency travel changes or repatriation.
US National Cancer Institute guidance also distinguishes research costs from routine patient-care and travel costs. For a China-based study, the applicable Chinese rules, consent form and the site’s written cost explanation should be used to confirm the actual arrangement. The same practical lesson applies: ask which items are paid by the sponsor, hospital, insurer or participant before travelling.
Questions to ask the research centre about costs
Which tests, admissions, medicines and procedures are considered research-related?
Are screening tests covered if the patient is later found ineligible?
Who pays for bridging therapy before leukapheresis or infusion?
What happens financially if cell manufacturing fails or the product cannot be released?
Which adverse-event and complication costs are covered, and what study-related injury insurance applies?
Are travel, accommodation or caregiver reimbursements available to an overseas participant?
Which costs may continue during long-term follow-up, and can the site provide the explanation in writing before travel is booked?
What Does a Commercial CAR-T Estimate Need to Include?
A commercial product price is not the same as the complete medical cost. A useful estimate should distinguish:
initial specialist review and repeat diagnostic work;
pathology or biomarker confirmation;
leukapheresis and cell-processing charges;
CAR-T product or manufacturing payment stages;
bridging therapy, if prescribed;
lymphodepleting chemotherapy;
inpatient admission and routine monitoring;
medicines, blood products, infection treatment and supportive care;
management of complications, including any intensive-care or prolonged-stay charges;
repeat assessment, readmission and follow-up; and
charges that are refundable or non-refundable if collection or manufacturing cannot proceed.
The estimate should name the intended product and hospital. A quote based only on the term “CAR-T package” is not sufficient for comparing pathways.
For broader background on pricing and cross-border access, read our guide to CAR-T therapy cost and access in China. Before relying on any quoted figure, request an itemised written estimate from the treating institution.
Is Commercial CAR-T Faster Than a Clinical Trial?
Sometimes it may offer a more defined route, but “commercial equals fast” is not a reliable rule. A commercial pathway can still be delayed by:
incomplete records or repeat testing;
recovery from recent chemotherapy;
uncontrolled infection or organ dysfunction;
apheresis readiness;
manufacturing capacity or product release;
hospital bed and monitoring capacity; or
rapid clinical deterioration that changes the risk assessment.
A trial pathway can be delayed by additional protocol review, cohort availability, sponsor confirmation, biomarker central review, research consent and on-site screening. However, a currently open site with an available cohort may sometimes review quickly. Timing must be confirmed for the actual centre and patient; it cannot be inferred from pathway labels.
No family should delay urgent local disease-control treatment because a trial email has not yet been answered. Cross-border coordination is not an emergency pathway.
Can Families Explore Both Pathways at the Same Time?
Administrative enquiries may sometimes proceed in parallel, provided the patient authorises each submission and all teams receive accurate, current information. Parallel review does not mean parallel treatment. The family should disclose:
every treatment that is ongoing or planned;
exact drug and corticosteroid dates;
new infections, admissions or complications;
other hospitals or studies currently reviewing the case; and
any consent, screening or collection step already completed.
Do not accept conflicting medication or timing instructions from informal sources. If two centres propose different sequences, ask the local oncologist and responsible receiving specialists to reconcile them before any treatment change.
What Should International Patients Confirm Before Travelling?
Travel should be tied to a documented institutional step, not to hope created by an online trial listing. Before booking long-haul travel, request written answers to the following:
Has the case only been received, or has it passed a remote pre-screen?
Is the pathway commercial treatment, an NMPA drug trial or another registered/filed research programme, and what are its product, target, phase and identifier?
Does the specific site currently accept overseas patients for this pathway?
Which records or samples must arrive before travel, which tests must be repeated in China and who pays if screening fails?
Is there a confirmed screening, apheresis or admission appointment?
What treatment may continue locally while the review is pending?
What stay, caregiver presence, follow-up and emergency-care arrangements are expected?
What visa or hospital-supporting documents can be issued after acceptance?
Flights and accommodation should remain flexible until the receiving institution confirms the next step. The local team should also assess whether the patient is medically fit to fly.
How MedBridgeNZ Supports a Two-Pathway Review
For international patients, the first difficulty is often not choosing a product. It is getting the same complete, dated case file in front of the correct commercial and research channels and obtaining comparable answers. MedBridgeNZ can:
compile and translate a chronological treatment summary from the records supplied without changing their medical meaning;
prepare pathology, biomarker, laboratory and imaging inventories and identify missing administrative information;
request the commercial product name, approved indication and hospital assessment process;
request the trial title, registry or filing identifier, site-level recruitment status and international-patient policy;
ask for written clarification of screening, timing and cost boundaries;
facilitate remote specialist review, MDT communication or an institutional consultation where available; and
coordinate registration, visa-support documents, travel, accommodation and bilingual assistance after a hospital or research site confirms the pathway.
MedBridgeNZ does not:
interpret a biomarker as proof of eligibility;
recommend commercial treatment over a clinical trial, or the reverse;
calculate a washout period;
tell a patient to stop or delay chemotherapy;
determine whether a protocol can accept an international participant;
guarantee a trial place, manufacturing slot, clinical outcome or cost; or
provide emergency assessment, toxicity management or direct medical care.
Need Help Preparing Records for Both Pathways?
MedBridgeNZ can help prepare the same complete, dated record set for commercial and research enquiries, translate the supplied documents and request written clarification from the relevant institution. Hospitals and research teams independently decide clinical suitability, screening and trial enrolment.
For help with medical-record preparation, institutional liaison and travel logistics, learn more about MedBridgeNZ’s medical concierge and treatment coordination services in China.
Representative Administrative Pathway
The following is a composite illustration based on recurring international-patient questions. It does not describe a specific MedBridgeNZ patient.
A patient or family supplies pathology, biomarker results, imaging, DICOM files, laboratory results, a dated treatment chronology, current medicines and relevant complications.
MedBridgeNZ compiles and translates the file and, with authorisation, routes it to an institutional commercial channel and/or a research site whose stated scope appears relevant to the documented diagnosis.
For the commercial pathway, the receiving hospital’s designated CAR-T clinical team determines whether the patient can proceed to product-specific assessment under a currently approved indication and requests any additional tests. For the research pathway, the relevant hospital study team or trial investigator reviews the applicable protocol, confirms whether the specific site and cohort are currently screening, and states whether international participants may be considered. These are institutional clinical and research decisions; MedBridgeNZ does not determine product suitability or trial eligibility.
Neither response is treated as final eligibility. The family obtains written information about screening, recent-treatment timing, apheresis, manufacturing, costs, travel and follow-up.
The local oncologist remains responsible for urgent treatment while the overseas review proceeds. Any proposed timing change is coordinated with the responsible receiving team.
Travel is arranged only after the institution confirms the next clinical or screening step and the patient is considered fit to travel.
Individual access and outcomes vary with the disease, antigen, prior treatment, current clinical status, product or protocol rules, site capacity and changes during review.
Frequently Asked Questions
Does an NMPA-approved CAR-T product mean I am eligible?
No. Approval applies to the product and registered indication. The treating hospital must still review the diagnosis, target, prior therapy, current condition, collection and manufacturing feasibility, risks and institutional availability.
Can international patients join CAR-T clinical trials in China?
Sometimes, but there is no universal answer. The protocol and the specific site must confirm whether an overseas resident can be screened, consented, treated and followed. A public registry entry does not establish site-level acceptance.
Is CAR-T in a Chinese clinical trial completely free?
Do not assume that. Applicable Chinese rules prohibit charging participants fees related to the trial or covered clinical research, but the site must define what is research-related. Routine care, non-study treatment, screen-failure care, translation, travel and accommodation may require separate arrangements.
Is commercial CAR-T always faster than a trial?
No. Commercial access may have a clearer operational and payment route, while trial access has protocol and cohort requirements. Either can be delayed by medical instability, recovery, apheresis, manufacturing, bed capacity or incomplete records.
Does “Recruiting” on ClinicalTrials.gov guarantee the China site is open?
No. Verify the individual location, cohort and current site contact. Also check the Chinese CTR record for an NMPA-regulated drug trial. The research team must confirm current site-level screening.
Can a recent chemotherapy cycle prevent trial enrolment?
It may affect timing or protocol eligibility, but there is no universal rule. Provide the exact drugs, doses and dates. The local oncologist and receiving team must coordinate disease control, washout, blood-count recovery and any collection plan.
Should I delay chemotherapy while waiting for a China trial reply?
No patient should delay or change planned treatment because of an online article or an unanswered overseas enquiry. Urgent treatment decisions remain with the local treating team. Ask the prospective CAR-T centre to review the exact treatment schedule as quickly as its process allows.
Can I travel after a remote pre-screen says I may qualify?
Only after clarifying what the pre-screen means. It may support further assessment but usually does not confirm final eligibility, apheresis, manufacturing, admission or infusion. Request a written screening plan and ask the local team to assess fitness to fly.
Choosing the Next Administrative Step
The first decision is usually not “commercial or trial?” It is whether the records are complete enough for the responsible teams to answer the comparison safely.
Prepare the exact diagnosis, pathology, biomarkers, prior treatments and dates, current disease status, laboratory trends, infections, medicines, organ-function information and planned next treatment. Then ask each institution to identify its pathway, evidence stage, screening rules, cost boundary, current availability and international-patient process in writing.
Patients seeking medical-record translation, institutional submission or cross-border CAR-T coordination can contact the MedBridgeNZ Patient Care Team to request record coordination. The receiving hospital or research team makes every clinical and enrolment decision.
Patients seeking medical-record translation, institutional submission or cross-border CAR-T coordination can submit a CAR-T coordination enquiry to the MedBridgeNZ Patient Care Team. MedBridgeNZ can assist with record preparation, translation and institutional liaison, while the receiving hospital’s clinical team or the relevant study investigators make all clinical suitability and enrolment decisions.
Disclaimer: MedBridgeNZ acts strictly as an international medical concierge and logistics coordinator. We do not provide direct medical treatment, diagnosis, clinical advice, trial enrolment decisions or emergency care. This content is for general informational purposes and does not constitute medical, legal or financial advice. Always consult the treating oncologist before changing treatment or pursuing a cross-border treatment pathway. A medically unstable patient should remain under local clinical care; overseas coordination should not delay urgent assessment or treatment.
References
National Medical Products Administration. NMPA Approves Satricabtagene Autoleucel Injection (22 June 2026). Full URL: https://www.nmpa.gov.cn/zhuanti/cxylqx/cxypxx/20260622143203120.html
National Medical Products Administration. 2021 Drug Evaluation Report, including China’s first commercial CAR-T approvals for specified blood-cancer indications. Full URL: https://www.nmpa.gov.cn/directory/web/nmpa/xxgk/fgwj/gzwj/gzwjyp/20220601110541120.html
National Medical Products Administration. NMPA Conditionally Approves Equecabtagene Autoleucel Injection, a BCMA-directed CAR-T product (30 June 2023). Full URL: https://www.nmpa.gov.cn/zhuanti/ypqxgg/gggzjzh/20230630195006116.html
National Medical Products Administration. Drug Clinical Trial Registration — official registration and information-disclosure process. Full URL: https://zwfw.nmpa.gov.cn/web/taskview/11100000MB0341032Y100207202900001
National Medical Products Administration. Regulations for the Implementation of the Drug Administration Law of the People’s Republic of China (2026), including the rule that sponsors and trial institutions must not charge participants fees related to a drug clinical trial. Full URL: https://www.nmpa.gov.cn/xxgk/fgwj/flxzhfg/20260127172639127.html
National Medical Products Administration. Drug Administration Law of the People’s Republic of China, including informed-consent requirements for drug trials. Full URL: https://www.nmpa.gov.cn/xxgk/fgwj/flxzhfg/20190827083801685.html
State Council of the People’s Republic of China. Regulation on the Administration of Clinical Research and Clinical Translation of New Biomedical Technologies, State Council Order No. 818, effective 1 May 2026. Full URL: https://www.mee.gov.cn/zcwj/gwywj/202510/t20251011_1129176.shtml
ClinicalTrials.gov. How to Read a Study Record. Full URL: https://clinicaltrials.gov/study-basics/how-to-read-study-record
ClinicalTrials.gov. How to Join a Study. Full URL: https://clinicaltrials.gov/find-studies/for-patients/how-to-join
US National Cancer Institute. Who Pays for Clinical Trials? Full URL: https://www.cancer.gov/research/participate/clinical-trials/paying
