Lessons learned from clinical trial queries on small biopsy collections: importance of rapid on-site evaluation

•This investigation shows the recent high volume of clinical trial biopsies managed at an academic cancer center.•Although feedback from trials was limited, the communication frequently involved suboptimal cases without rapid on-site evaluation (ROSE) by cytopathology at acquisition, which has led to more widespread adoption of ROSE to mitigate insufficient biopsies and repeat procedures.•The high volume of clinical trial biopsies and variability in trial needs necessitates a collaborative multi-disciplinary network, including cytology services, to facilitate these important biopsies for cancer patients.