In a study looking at the differences and trends in the inclusion of women, minorities, and patients with advanced cancer in clinical trials, investigators found that certain populations remain under-represented. However, participation has increased for certain patients, such as Black and Hispanic. These findings were published online by Wiley in CANCER which is an American Cancer Society peer-reviewed journal.
By including people from diverse backgrounds Clinical trials can determine whether treatments are safe and effective for individuals with different characteristics. The National Cancer Institute (NCI) has created a number of initiatives to encourage such diversity in the clinical trials it finances.
Juan F. Javier-DesLoges MD, MS of UC San Diego Health, and his team of researchers studied the NCI Clinical Data Update System, a database that contains details about participants in NCI-sponsored clinical trials, to assess the representation of women, minorities, and older patients in 766 colorectal, breast, prostate cancer, and lung trials from 2000 to 2019.
The analysis involved 242,720 participants, including 197,320 non-Hispanic white (81.3 percent) and 21,190 Black (8.7 percent) and 115,87 Hispanic (4.8 percent), 6,880 Asian/Pacific Islander (2.2%) patients.
Researchers compared the 2015-2019 trial participation to the proportions of cancer-related incidence rates for non-Hispanic whites and minorities and elderly patients versus those who are not and female patients versus male patients.
In these comparisons of trial participation with cancer rates, Black and Hispanic patients were more likely to participate in clinical trials for breast cancer, but were not as represented in lung, colorectal and prostate cancer trials; patients over 65 years of age were under-represented in colorectal, breast, and lung cancer trials; and women were underrepresented in lung and colorectal cancer trials.
When the investigators compared the years 2000-2004 to the years 2015-2019 they found that Hispanic and Black patients were more likely to be included in lung, breast and prostate cancer trials in the last few years compared with the early 2000s. Women were less likely to be included in trials for colorectal cancers in recent years, however they were more likely to participate in lung cancer trials. The trends in the inclusion of patients over 65 years old varied according to the type of cancer.
Our study indicates that the disparity for clinical participation in NCI clinical trials has narrowed for minorities, but more efforts are required.”
Juan F. Javier-DesLoges, MD, MS, UC San Diego Health
It is also important to address the issue of under-representation of older and female patients in clinical trials.
Javier-DesLoges J., and al. (2021). Trends and differences in the participation of minorities, women, and the elderly in breast and colorectal, prostate cancer and lung trials. Cancer. doi.org/10.1002/cncr.33991.
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