IMPROVING DIVERSE PARTICIPATION IN CANCER CLINICAL TRIALS.

Abstract

Despite significant improvement in overall cancer mortality (>30% since 1991), these survival benefits have not been experienced by all groups uniformly especially in those of diverse heritage. Drivers of cancer health inequity are multi-factorial including more adverse social determinants of health, later stage cancer presentation, decreased health care access, decreased health literacy, and cultural barriers to prompt cancer care. Adding to these disparities is the historical inclusion of primarily well-insured Caucasian patients into cancer clinical trials leading to deep gaps in understanding both the efficacy and safety of new therapies in the actual populations for which these medications will be used. The need for trial accruals to reflect the U.S. population (i.e., diverse) is essential across diseases, but especially those in which certain minority populations are overrepresented (Latinos and hepatocellular carcinoma, African Americans and myeloma and prostate cancer). Strategies and new legislation to increase diversity in trial accruals are outlined and discussed.