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By D’Ann George, PhD, Medical Writer

Racial and ethnic diversity in clinical trials, and the lack of it, was a major theme across research presented at the 2022 meeting of the American Society of Clinical Oncology, held in Chicago, Illinois on June 3-7. Trial participation is generally low among adults with cancer even though trials are an important way to access effective treatment. Additional barriers may contribute to particularly low participation by black, Hispanic, indigenous, and other minority populations.  

During a panel on advancing equity in clinical trials, Dr. Lori Pierce of the University of Michigan, suggested that researchers need to do a better job matching patients with trials and then follow up by asking them to join a trial.

Dr. Sana Ali

“We need to just ask patients to go on studies, because when you do, the data has shown that patients, regardless of race and ethnicity, will go on trials at the same rate,” she said.  

Some studies focused on racial and ethnic disparities in outcomes. One retrospective study found that Hispanic/Latinx people with metastatic renal cell carcinoma (RCC) experienced poorer outcomes than non-Hispanic patients after treatment with combination immunotherapy nivolumab plus ipilimumab. After 12 months, only 19% of Hispanic patients were alive and progression free, compared to 38% of non-Hispanic patients. The study controlled for several characteristics: type of health system, age, IMDC risk classification, BMI, and several comorbidities. (Abstract 4554)

Presenter Dr. Sana Ali of Harbor-UCLA Medical Center said that researchers do not yet know why there is a disparity in outcomes among different racial and ethnic groups. 

“I think historically and traditionally we chalk this up to a very complex interaction between like biologic and social determinants of health. But there’s a lot of recent literature coming out as well, that even when we controlled for those two things, these disparities persist.”

Ali hinted at a direction for future research.

“I think we’re beginning to ask ourselves, is there a difference in immune make up of each ethnicity that really shapes how they respond to these immunotherapies?”

Another retrospective study examined potential differences in treatments offered to African Americans versus White Americans who have advanced renal cell carcinoma, and the corresponding impact of any differences. While the researcher, Dr. Daniel Geynisman of Fox Chase Cancer Center, found no significant difference in the kinds of therapy patients received across racial groups, with both groups receiving immune-based combinations, he did find that WAs had a higher response rate than AAs. (Abstract 4548)

“The next steps would be to extend follow-up and to investigate why the response rates are different,” he said. “[The disparity] may have been a spurious finding due the sample size or the retrospective conduct of the analysis.”

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