Two prominent forces in United States-based cancer research came together to drive greater diversity in clinical research. For too long, clinical trial participation hasn’t represented the demographics of the American population at large. The American Society of Clinical Oncology (ASCO) and the Association of Community Cancer Centers (ACCC) have formed a joint initiative designed to identify and implement novel strategies and practical solutions to increase clinical trial participation of racial and ethnic minority populations that continue to be under-represented in cancer research. Of particular concern is to boost the participation of two of America’s largest minority groups, namely African Americans and Hispanics (Latinos).
According to recent analyses, African Americans represent 4% to 6% of trial participants, while Hispanics/Latinos represent 3% to 6%. Yet Blacks represent at least 15% and Latino/Hispanic 13% of all cancer cases. Lori J. Pierce, MD, FASTRO, FASCO, co-chair of the ASCO-ACCC Steering Group, is overseeing this initiative: “We are committed to providing evidence-based high-quality cancer care to every patient, every day, everywhere.” She continued, “But, if clinical trials don’t represent the individuals we treat, including those from racial and ethnic minority populations, the state of science suffers, and patients with life-threatening conditions may miss out on the best—perhaps only—treatment option for their condition. This initiative is of critical importance, and we’re honored to be working with ACCC to address long standing barriers to diversity in cancer treatment trials.”
What are the Barriers to Diversity in Cancer Trials?
The ASCO-ACCC seeks collaboration with other organizations in the cancer community to come up with novel approaches and practical solutions to boost cancer trial participation within targeted underrepresented populations. Challenges or barriers can be segmented into economic, institutional, cultural, and educational. Some specific examples could include access and financial wherewithal (no time or financial resources to participate) to bias at the institutional and individual level to cultural or literacy-related issues, study design barriers, or other factors such as barriers to family and community engagement, suggests ASCO.
TrialSite principals have been involved with clinical trials over the decades and have found these ongoing challenges to be pervasive. See the African American clinical trials disparity survey for additional ideas.
Call for Ideas
The ASCO-ACCC alliance issued a Request for Ideas (RFI) to elicit novel strategies and practical solutions to help diversity clinical trial participation. An ASCO-ACCC Steering Group has been established to review and select potential ideas. In a bid to infuse good ideas directly into the real world, the ASCO-ACCC team may implement and evaluate top ideas via the ASCO Targeted Agent and Profiling Utilization Registry (TAPUR™) study.
ASCO (American Society of Clinical Oncology) is a professional organization representing physicians of all oncology sub-specialties who care for people with cancer. The group was formed in 1964 and today counts almost 45,000 members. While ACCC (Association of Community Cancer Centers) is a community of over 25,000 multidisciplinary practitioners and 2,100 cancer programs and practices around the country. Founded in 1974, ACCC brings together healthcare professionals across all disciplines in oncology to promote quality cancer care. It is estimated that 65 percent of the United States’ cancer patients are treated by a member of ACCC.