Strategies developed to include more racial and ethnic minorities in clinical trials

March 06, 2019

Not one size fits all, and nowhere does that show up more than in the recruitment of racial and ethnic minorities into clinical trials, says Hollings Cancer Center researcher Marvella Ford, Ph.D. This is critically important since this population has a high prevalence of certain cancers.

Ford, who is associate director of population sciences and cancer disparities at MUSC Hollings Cancer Center, was part of a study involving eight cancer centers that was published on March 4 in the American Society of Clinical Oncology's Journal of Oncology Practice. A guide looking at best practices across all the different sites, the study provides recommendations of how these populations can best be engaged in clinical trials, she says.

"This is a major focus of the National Cancer Institute the National Institutes of Health, and it's very important because we need to make sure that at the end of the day the research results can be generalized across multiple population groups," she says. "We can't use a one-size-fits-all approach and use the same recruitment strategies in every single group and expect to get positive results. We really have to tailor the recruitment strategies to the needs of the group."

The study summarizes the need for the development of innovative strategies to address the issue. African American patients comprise 5 percent of patients enrolled in clinical trials that support U.S. Food and Drug Administration approval of new drugs, but they represent 13 percent of the general US population. Cancer is the leading cause of death for Asian Americans, yet this population comprises 3 percent of cancer clinical trial participants, and Hispanics also are similarly underrepresented.

Ford says researchers and cancer centers have to take a different tack with racial and ethnic minority groups. "We can't recruit all groups the same because different groups have different relationships with the healthcare system, they have different histories, and they have different histories of past abuses with the healthcare system and with the federal government."

Though minority enrollment in clinical trials tends to be low in general, it's particularly an issue in cancer, where advances in research are driving a paradigm shift in precision medicine. It's important that the development of personalized medicines that account for biologic factors, such as genetics, gender, race, and ethnicity have a diverse pool of participants. It's also important that these populations have access to the latest advances in promising novel therapies, from immunotherapy to recently discovered genetic therapies.

Ford says the exchange of information among major thought leaders helps move the needle forward. What she found surprising was that all centers, regardless of resources, expressed difficulty in recruiting racial and ethnic minority groups.

The care delivery study found centers achieving sustainable high recruitment of racial and ethnic minority groups did so by excelling in:A key component in increased inclusion is the development of trust in the community. One tactic Hollings Cancer Center uses is its MOVENUP Program that takes a train-the-trainer approach in rural communities that are medically underserved. This training covers cancer prevention, screening and treatment options and includes a module focused on clinical trials and their vital role in developing new, more effective approaches to prevent, diagnose and treat cancer.

That program now is being expanded in a new partnership with the Seventh Episcopal District of the African Methodist Episcopal Church, with monthly programs planned to reach its more than 400 churches spread across the state. The four-hour cancer education training program includes a module on clinical trials.

This helps develop relationships and build trust. Ford says it takes a shift in perspective in designing trials that are tailored to communities.

"We can't just allow three months of recruitment time for a population that has historically been disassociated or disenfranchised from the health care system. Because in that three-month period, we can't build trust and develop those relationships. We can't do all of the things that have to be done to successfully recruit in three months."

Though research is about data, the core of it is about people, Ford says.

"We want to bring in community members and talk to them and bring in key people from the community who can advocate for the trials that we're conducting. All that takes time because from the community's perspective, it's all about relationships. They want a relationship with the people who are conducting the trial. They don't want a nameless, faceless entity. That doesn't mean anything to them. It won't be successful," she says.
-end-
About Hollings Cancer Center

The Hollings Cancer Center at the Medical University of South Carolina is a National Cancer Institute-designated cancer center and the largest academic-based cancer research program in South Carolina. The cancer center is comprised of more than 120 faculty cancer scientists with a research funding portfolio of $44 million and a dedication to reducing the cancer burden in South Carolina. Hollings offers state-of-the-art diagnostic capabilities, therapies and surgical techniques within multidisciplinary clinics that include surgeons, medical oncologists, radiation therapists, radiologists, pathologists, psychologists and other specialists equipped for the full range of cancer care, including more than 200 clinical trials. For more information, please visit http://www.hollingscancercenter.org.

Medical University of South Carolina

Related Cancer Articles from Brightsurf:

New blood cancer treatment works by selectively interfering with cancer cell signalling
University of Alberta scientists have identified the mechanism of action behind a new type of precision cancer drug for blood cancers that is set for human trials, according to research published in Nature Communications.

UCI researchers uncover cancer cell vulnerabilities; may lead to better cancer therapies
A new University of California, Irvine-led study reveals a protein responsible for genetic changes resulting in a variety of cancers, may also be the key to more effective, targeted cancer therapy.

Breast cancer treatment costs highest among young women with metastic cancer
In a fight for their lives, young women, age 18-44, spend double the amount of older women to survive metastatic breast cancer, according to a large statewide study by the University of North Carolina at Chapel Hill.

Cancer mortality continues steady decline, driven by progress against lung cancer
The cancer death rate declined by 29% from 1991 to 2017, including a 2.2% drop from 2016 to 2017, the largest single-year drop in cancer mortality ever reported.

Stress in cervical cancer patients associated with higher risk of cancer-specific mortality
Psychological stress was associated with a higher risk of cancer-specific mortality in women diagnosed with cervical cancer.

Cancer-sniffing dogs 97% accurate in identifying lung cancer, according to study in JAOA
The next step will be to further fractionate the samples based on chemical and physical properties, presenting them back to the dogs until the specific biomarkers for each cancer are identified.

Moffitt Cancer Center researchers identify one way T cell function may fail in cancer
Moffitt Cancer Center researchers have discovered a mechanism by which one type of immune cell, CD8+ T cells, can become dysfunctional, impeding its ability to seek and kill cancer cells.

More cancer survivors, fewer cancer specialists point to challenge in meeting care needs
An aging population, a growing number of cancer survivors, and a projected shortage of cancer care providers will result in a challenge in delivering the care for cancer survivors in the United States if systemic changes are not made.

New cancer vaccine platform a potential tool for efficacious targeted cancer therapy
Researchers at the University of Helsinki have discovered a solution in the form of a cancer vaccine platform for improving the efficacy of oncolytic viruses used in cancer treatment.

American Cancer Society outlines blueprint for cancer control in the 21st century
The American Cancer Society is outlining its vision for cancer control in the decades ahead in a series of articles that forms the basis of a national cancer control plan.

Read More: Cancer News and Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.