In a study that looked at disparities and trends in the participation of minorities, women, and older patients in cancer clinical trials, researchers discovered that some groups are still underrepresented. However, engagement among some patients, particularly black and Hispanic patients, has increased in recent years. The findings were published in CANCER, a peer-reviewed publication of the American Cancer Society, by Wiley online.
Clinical trials can show if therapies are safe and effective for people with various characteristics by including people from various backgrounds. Multiple programs have been launched by the National Cancer Institute (NCI) to foster such variety in the clinical studies it finances.
Juan F. Javier-DesLoges, MD, MS, of UC San Diego Health and colleagues examined the NCI Clinical Data Update System, a database that contains information about participants in NCI-sponsored clinical trials, from 2000 to 2019 to assess the representation of minorities, women, and older patients in 766 breast, colorectal, lung, and prostate cancer trials.
There were 242,720 patients in the trials studied, with 197,320 non-Hispanic whites (81.3%), 21,190 blacks (8.7%), 11,587 Hispanics (4.8%), and 6,880 Asian/Pacific Islander (2.8%) patients.
The researchers examined non-Hispanic whites vs minorities, elderly versus nonelderly patients, and female versus male patients’ clinical trial participation from 2015 to 2019 to the proportion of cancer incidence rates from 2015 to 2017.
In these comparisons of trial participation with cancer incidence rates, Black and Hispanic patients were more likely to participate in breast cancer clinical trials, but were underrepresented in colorectal, lung, and prostate cancer trials; patients over 65 years old were underrepresented in breast, colorectal, and lung cancer trials; and women were underrepresented in colorectal and lung cancer trials.
The researchers discovered that Hispanic and Black patients were more likely to be included in breast, lung, and prostate cancer studies in recent years than in the early 2000s when they compared the years 2000–2004 to 2015–2019. In recent years, women have been less likely to be included in colorectal cancer trials, but more likely to be included in lung cancer trials. The percentage of patients above the age of 65 who were included in the study varied depending on the type of cancer.
Our article indicates that the disparity for clinical enrollment in NCI clinical trials has narrowed for minorities, but further efforts are still needed.”
Juan F. Javier-DesLoges, MD, MS, UC San Diego Health
There is obviously more effort to be done to address the persistent underrepresentation of women and older patients in clinical trials.