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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
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