Amidst the swell of racial injustice that the country is bringing to light, new research reports that Black patients are better represented in taxpayer-funded clinical trials testing new cancer treatments compared to trials run by pharmaceutical companies. This finding, published in April this year in JNCI Cancer Spectrum, will be presented this week at the 2020 American Association for Cancer Research (AACR) Virtual Annual Meeting II.
To put these findings into context, it is essential to know that Black patients are not fully represented in cancer clinical trials, regardless of who is the sponsor. These cancer disparities are a crucial part of the greater picture of racial injustice that we need to expose.
The study was led by Joseph Unger, PhD, who specializes in cancer disparities research, particularly in regards to the impacts of insurance status, race and ethnicity, and income on health outcomes. Unger is a biostatistician at SWOG Cancer Research Network, a member of the National Cancer Institute's National Clinical Trials Network (NCTN), which has run thousands of trials over the last 60 years.
In this study, Unger analyzed black enrollment in NCI-sponsored trials and industry-sponsored trials. "It's a critical question," Unger said. "Trials are an important way - sometimes the only way - for cancer patients to receive potentially breakthrough drugs. Everyone can get cancer, so everyone should have the same access to investigational cancer treatments. In addition, it's very important from a scientific standpoint to evaluate new treatments in patients who reflect the demographics of the general cancer population."
"This study confirmed that black cancer patients are severely underrepresented in pharmaceutical company-sponsored trials, with fewer than one in four of the expected number enrolled," Unger said. "Black representation in industry trials was also far below that of NCTN trials, with only one black patient enrolled for every three enrolled in NCTN trials."
The research team took data from 358 trials, 85 of which were from industry and 273 of which were SWOG trials. From the years of 2003 to 2018, these trials enrolled 93,825 patients being treated for 15 different cancer types. They found that the rate of black enrollment in industry trials was 3%, compared to 9% in SWOG trials and 12% in the corresponding U.S. cancer population.
Unger hopes that presenting the findings from this study will improve the representation of Black patients throughout all clinical trials. "NCI sponsored trials have a broader mandate," he said. "They reach beyond just the major cancer centers to serve patients in a more diverse community-based clinical setting. This could serve as a model for pharma trials aiming to increase the representativeness of all patients."