Have You Seen This?
Increasing Diversity in Cancer Clinical Trials
Novembr 23, 2022
DELRAY BEACH, FL – Clinical trials are vital to the development of effective drugs and therapies that increase the overall survival of cancer patients; however, very few cancer patients are able to participate, and are typically less diverse than the affected population. “Trials that are less diverse raise questions about the generalizability of results for clinical decision making and contribute to persistent racial disparities in cancer outcomes.”1
“Recent analyses of cancer therapeutic trails found that only 4%-6% of trial participants are Black and 3%-6% are Hispanic, despite representing 15% and 13% of people with cancer, respectively.”1 Barriers to participation include factors that arise from the clinician, the patient and even the trial, itself. Clinician biases may hinder which patient they offer the trial to or lack the resources necessary to make sure that trials are being offered to all eligible patients. “Research suggests that more than 50% of people with cancer do not participate in trials because they lack information, no local trial is available, and/or a trial does not match their disease characteristics.”1 Financial, language, and health literacy barriers to participation could also be a factor and may disproportionately affect racial and ethnic minority populations. The eligibility criteria of a clinical trial may exclude based on several factors, some of which may be more prevalent in some populations over others, and unknowingly be creating patient sample that is less diverse.
“Because the problem stems from multiple factors, multifaceted strategies are needed to increase participation among people from racial and ethnic minority poplulations.”1 The American Society of Clinical Oncology (ASCO) and the Association of Community Cancer Centers (ACCC) recently put out a joint research statement to present recommendations, as well as strategies, on how the research community can better the equity, diversity, and inclusion (EDI) within cancer clinical trials. The general recommendations are the following:1
- 1) Clinical trials are an integral component of high-quality cancer care, and every person with cancer should have the opportunity to participate
-
2) Trial sponsors and investigators should design and implement trials with a focus on reducing barriers and enhancing EDI, and work with sites to conduct trials in ways that increase participation of under-represented populations -
3) Trial sponsors, researchers, and sites should form long-standing partnerships with patients, patient advocacy groups, and community leaders and groups
- 4) Anyone designing or conducting trials should complete recurring education, training, and evaluation to demonstrate and maintain cross-cultural competencies, mitigation of bias, effective communication, and a commitment to achieving EDI
-
5) Research stakeholders should invest in programs and policies that increase EDI in trials and in the research workforce -
6) Research stakeholders should collect and publish aggregate data on racial and ethnic diversity of trial participants when reporting results of trials, programs, and interventions in increases EDI
The ASCO and the ACCC both recognize that these recommendations are not all-inclusive but are necessary to see any real progress in trial and treatment diversity. The “diversity among participants is key to understanding intrinsic and extrinsic factors that may affect patient response to therapies, ensuring the safety and efficacy of new cancer therapeutics, and achieving equitable high-quality cancer care for all people with cancer.”1
- Oyer RA, Hurley P, Boehmer L, et al. Increasing Racial and Ethnic Diversity in Cancer Clinical Trials: An American Society of Clinical Oncology and Association of Community Cancer Centers Joint Research Statement. J Clin Oncol. 2022;40(19):2163-2171. doi:10.1200/JCO.22.00754