Tuesday, July 22, 2014

Diversity in clinical trials lacking, study finds

From page A3 | March 19, 2014 |

Less than 5 percent of participants in National Cancer Institute-funded clinical trials are minorities, according to a newly published paper by UC Davis researchers.

They also found that less than 2 percent of clinical cancer research studies focus on non-whites. In 1993, Congress mandated the inclusion of women and minorities in trials funded by the National Institutes of Health, of the which the cancer institute is a part.

“The proportion of minorities in clinical research remains very low and is not representative of the U.S. population with cancer,” said Moon Chen, of UCD Comprehensive Cancer Center and leader of the study in a news release. “What is needed is a deliberate effort. Minorities are not hard to reach. They are hardly reached.”

UCD researchers analyzed citations from medical journals to reach their conclusion. They found only about 150 trials out of 10,000 funded by the National Cancer Institute met the 2 percent criteria.

Participation varies depending on age, the researchers found, with 60 percent of patients ages 15 and younger taking part in studies. Minority representation in those trials is “excellent,” researchers said.

Only to 3 to 5 percent of adult patients take part in trials, but the proportion of adults from minority ethnic and racial groups who take part does not match the country’s population as a whole, however.

For instance, black Americans experience the highest incidence of cancer, at 593.7 cases per 100,000 people, but, along with Hispanics, they have the lowest cancer clinical trials participation: 1.3 percent.

The UCD cancer center’s associate director for clinical research and study co-author, Karen Kelly, said that the value of a more diverse group of participants is well-documented.

For instance, the discovery that a genetic mutation predicted responsiveness to a particular oral therapy is more frequently found in patients in Asia than in Americans changed how lung center is treated around the world.

“Clinical trials in diverse populations can help us understand the biology of disease, and why a drug may produce a higher response rate and higher toxicity in one group than in another,” Kelly said. “Moreover, by targeting the population most likely to benefit from a novel treatment we can accrue patients more quickly to clinical trials that will lead to faster results.”

The researchers argue that clinical trials should be designed to include or focus on specific populations — and journals should insist on minority representation.

“The solution is not changing the attitudes of minorities but rather in ensuring access to health research,” they write.

UCD’s cancer center has begun taking steps in that direction. For instance, it’s home to a new program that provides culturally sensitive educational materials to Asian-American cancer patients.

The journal Cancer published the study online Tuesday.

Cory Golden

Cory Golden

The Enterprise's higher-education and congressional reporter. http://about.me/cory_golden

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