Oncology trials are often multisite, multicountry large- scale endeavors, requiring collection of a wide range of data from participants. Traditionally, oncology trials have only been carried out at specialist hospitals with the infrastructure to support patients receiving experimental treatments. But with technological and logistical advances, there is opportunity to decentralize some of the components of an oncology trial. This decentralization can boost recruitment of eligible participants, improve patient experience and reduce burden on them and family members for ongoing participation. In turn, this supports patient retention and can improve trial efficiencies through the flow and review of near real-time participant data. In this article, we look at the key tools, technologies and processes that support real-time data review and facilitate more efficient clinical decision-making.