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Why We Need to Increase Diversity in Clinical Trials

Why We Need to Increase Diversity in Clinical Trials
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Published on February 20, 2020

Cancer patient volunteers are critical to the success of clinical trials (studies). While oncology researchers have made great strides through these trials that  accelerate approval of new, more effective therapies for patients with cancer, one of the biggest challenges is recruiting patients from diverse populations, so these new treatments can be proven useful for the greatest number of patients. 

Why Are Clinical Trials Important?

Cancer clinical trials are rigorously designed and monitored tests that help scientists find new ways to prevent, diagnose and treat cancer as well as manage cancer symptoms and treatment side effects. Without patients participating in these trials, innovative tests and treatments cannot be approved, because oncologists must base their recommendations on real evidence-based science. 

When first diagnosed, a patient may not think to ask if a clinical trial is available or if they might be eligible to participate. Each clinical trial has unique criteria for participation—these may include cancer type and stage, whether the patient has already been treated with a specific therapy (or treated at all), patient age, gender and current health status. When a treatment plan is presented, the oncologist should be asked whether there are trials that might be a potential treatment option. 

Lack of Diversity in Clinical Trials Hampers Progress

It’s crucial to include people from a wide swath of ethnic and racial backgrounds in clinical trials, because the effectiveness of a drug and its side effects may vary not only from person to person, but from group to group. Also, certain populations may be more likely to be carriers of a certain gene mutation—such as BRCA1/2 breast cancer—that are important for selecting the right treatment. This goes for men too, who not only can be carriers of this genetic mutation, but a small population of men are also at risk for breast cancer.  The numbers of trial participants need to be large and diverse so that findings are statistically meaningful and can be applied to further research in therapies, ultimately helping more patients.

One of the challenges with clinical trials is getting enough eligible patients to enroll. But what are some other barriers to participation? For one, patients may not know that a clinical trial exists. Factors such as location of the trial, transportation and childcare issues, work commitments, understanding of the trial process, all may affect whether a patient agrees to participate. Language barriers may also be a factor for both the doctor and patient. Watch this video where Dr. Richard Schilsky of the American Society of Clinical Oncology offers solutions to these challenges. 

Overcoming the Barriers

With the dizzying number of decisions patients are faced with when first diagnosed, it can be challenging to build a relationship with the team of doctors who are seeing individual pieces of the “puzzle” when you need to see the big picture. A patient navigator can help answer some of the logistics questions that come up when making a treatment plan.

The U.S. Food and Drug Administration is working hard to promote and change enrollment practices that broaden eligibility criteria for clinical trials. For some trials, age could be a limiting factor, but the significance of someone’s biological age can be different based on an individual’s health status. Many people with chronic illnesses are now living longer and have a good quality of life, regardless of the year they were born.

For more information, visit this section of the Patient Power website that has many videos that explain the basics of clinical trials.  Check out our Clinical Trial Finder tool that can  help you to conduct a search.

~Lauren Evoy Davis

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.


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