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PERSPECTIVE article

Front. Digit. Health

Sec. Health Informatics

UpSMART: five years of digital innovation in cancer clinical research – achievements, challenges, and recommendations

Provisionally accepted
Paul O'ReganPaul O'Regan1*Fouziah ButtFouziah Butt1Louise CarterLouise Carter2,3Donna Marie GrahamDonna Marie Graham2,3Anja Le BlancAnja Le Blanc1,4Richard HoskinsRichard Hoskins1,4Laura StephensonLaura Stephenson5Akshita PatilAkshita Patil1Muhammad ShabbirMuhammad Shabbir4Dilan EkenDilan Eken1Subir SinghSubir Singh1,2Andrea VillaAndrea Villa6Luca AgnelliLuca Agnelli6Silvia DamianSilvia Damian6Christopher GraveChristopher Grave4Giulia PretelliGiulia Pretelli7Elena GarraldaElena Garralda7Hannah FrostHannah Frost1Filippo De BraudFilippo De Braud6,8Andre FreitasAndre Freitas1,4,9Caroline DiveCaroline Dive1Harriet UnsworthHarriet Unsworth1
  • 1Cancer Research UK National Biomarker Centre, Manchester, United Kingdom
  • 2The Christie NHS Foundation Trust, Manchester, United Kingdom
  • 3The University of Manchester Faculty of Biology Medicine and Health, Manchester, United Kingdom
  • 4The University of Manchester, Manchester, United Kingdom
  • 5AstraZeneca R&D, Macclesfield, United Kingdom
  • 6Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
  • 7Vall d'Hebron Institut d'Oncologia, Barcelona, Spain
  • 8Department of Hemato-Oncology, University of Milan, Milan, Italy
  • 9Idiap Research Institute, Martigny, Switzerland

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UpSMART, a research programme involving 24 European cancer centres, aimed to promote digital innovation in early-phase clinical research addressing challenges in recruitment, data collection and analysis. Several open-source digital healthcare products (DHPs) were developed through UpSMART, including eTARGET and trialFinder for trial matching, and PROACT 2.0 for patient-reported data. Lessons learned highlight the importance of multidisciplinary teams, sustainable funding and deployment, and engagement with the research community to maximise impact.

Keywords: Digital Healthcare Products1, cancer clinical trials2, clinical trial innovation3, digitalhealth technologies4, open-source5

Received: 18 Sep 2025; Accepted: 04 Nov 2025.

Copyright: © 2025 O'Regan, Butt, Carter, Graham, Le Blanc, Hoskins, Stephenson, Patil, Shabbir, Eken, Singh, Villa, Agnelli, Damian, Grave, Pretelli, Garralda, Frost, De Braud, Freitas, Dive and Unsworth. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Paul O'Regan, paul.oregan@cruk.manchester.ac.uk

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Supplementary Material