Across 32 reviewed trials, digital or remote recruitment was documented in only a small minority of Phase III gastric, gastroesophageal, and esophageal cancer studies. Registry or advocacy-linked recruitment appeared even less often, suggesting most programs still rely on conventional site-led enrollment even when sample sizes and recruitment windows are operationally demanding.
Digital or remote recruitment appeared in 6.3% of reviewed trials. The signal was present in 2024 and 2025 but absent from the smaller 2026 cohort, so the data support selective use rather than a clear adoption trend.
Digital recruitment is not yet embedded in European Phase III gastric and esophageal cancer submissions. Its use appears tactical and trial-specific, not a routine design feature.
Registry or advocacy-linked recruitment was documented in 3.1% of reviewed trials. The only coded signal appeared in 2024, while the 2025 and 2026 cohorts showed no registry or advocacy recruitment flags in the extracted recruitment variable.
Patient-community infrastructure is rarely visible in these dossiers. For indications where biomarker status, prior therapy sequence, and referral concentration shape enrollment, this looks like an underused channel rather than a mature standard.
The most visible recruitment components were conventional printed materials and patient/HCP referral letters. Digital tools appeared mainly as eConsent, landing-page, online-posting, email, or ePRO-adjacent assets rather than as a dominant patient acquisition channel.
The operational pattern is still referral-heavy. The more mature packages combine physician letters, patient brochures, site identification tools, and selective digital consent or outreach assets, but those packages remain uncommon.
Trials with digital recruitment had a higher median planned sample size than trials without digital recruitment. The registry or advocacy-linked subgroup was represented by a single trial, so the scale signal should be read directionally rather than as a stable benchmark.
The strongest signal is not broad adoption but selective escalation. Digital and advocacy-linked strategies appear in larger trials, yet most large and long-running programs still show no explicit digital or community-based recruitment infrastructure.
European Phase III gastric, gastroesophageal, and esophageal cancer trials are still largely built around site-led enrollment. Digital, registry, and advocacy-linked channels appear in isolated dossiers rather than as standard infrastructure for a competitive oncology recruitment environment.
For medical directors and clinical development teams, recruitment planning in gastric and esophageal cancer should move earlier in protocol and country strategy. Where trials require biomarker pre-screening, referral from specialized oncology networks, or long enrollment windows, patient-access infrastructure should be designed upfront rather than treated as a late enrollment rescue tactic.