Stand Up to Cancer Takes Steps to Increase Diversity in Cancer Trials

Stand Up to Cancer Takes Steps to Increase Diversity in Cancer Trials
Group of multi-ethnic female athletes

Cancer research is rapidly advancing and mortality from the disease is dropping, but not all patients are benefiting equally. One recent review found that enrollment in pivotal trials leading to U.S. regulatory approval of immune checkpoint inhibitors showed poor representation of minority ethnic groups. Black patients constituted less than 4% of all patients enrolled across multiple trials supporting the approval of immune checkpoint inhibitors for lung cancer. Similar underrepresentation was observed in trials for renal cell carcinoma and other tumor types. Since these drugs typically only work in subsets of patients, it’s particularly important to determine who those subtypes are.

Now, Stand Up to Cancer (SU2C) is taking steps to increase minority representation in cancer trials. At the group’s annual Scientific Summit in Santa Monica, CA this week, SU2C announced several steps it is taking to address this disparity. First is a new initiative that requires all future SU2C-supported research grant proposals to address issues related to recruitment and retention of patients from ethnic groups.

Minority groups in the US have the lowest rates of participation in clinical trials, as well as the highest death rate and shortest survival rate for most cancers. According to the US Food and Drug Administration (FDA) only four percent of clinical trial participants are black, four percent are Hispanic, and 15 percent are Asian. This lack of diverse participation in cancer clinical trials is largely due to socio-economic, cultural, trust and other barriers.

“As one of the leading funders of cancer research, we believe it is our duty to ensure that minority representation in cancer clinical trials is addressed. Now, more than ever, better understanding of the role of biology in cancer treatment, advances in precision treatment, and development of new technologies demands that we also make significant improvements in diverse clinical trial participation,” said SU2C CEO Sung Poblete, Ph.D. “We are confident that this initiative will make a significant and meaningful impact to ensure all communities have equal access to potentially life-saving treatments.”

Specifically, applicants for funding from SU2C will now be required to include three critical components related to health equity:

  • An indication of whether the research will address the populations expected to benefit from widespread use of newly developed treatments;
  • Patient recruitment and retention plans for including historically underrepresented racial and ethnic populations – such as the need for additional trial sites or mechanisms to reduce barriers to access; and
  • A letter of support from the lead institution’s Chief Diversity Officer, or an equivalent position.

These factors will also be considered both in SU2C’s selection process, and as part of grant performance evaluation conducted in SU2C’s formal semi-annual reviews.

In addition, SU2C announced plans to fund up to $6.4 million for the group’s Health Equity Breakthroughs Research Team, which focuses on cancers affecting underrepresented populations. That team is supported by a grant from Genentech, a member of the Roche Group. SU2C is expected to issue the Request for Applications seeking proposals later in the first quarter of 2020. Proposals may address cancers that have a higher prevalence in a specific racial or ethnic population; cancers that are more deadly among specific minority populations; or the need for more effective treatments for specific cancers for patients of diverse backgrounds.

For example, gastric cancer is the third-leading cause of cancer death worldwide, and is more common in black, Hispanic, and Asian people than in caucasians.  At the Summit, SU2C introduced their new international SU2C Gastric Cancer Interception Research Team, which is looking for biomarkers and studying the use of a pill-sized camera that can be swallowed to capture images of stomach tissue.

SU2C will be also be collaborating with the Black Women’s Health Imperative (BWHI) and Friends of Cancer Research in Project TEACH: Trained Empowered Advocates for Community Health (Healing), funded by the Patient-Centered Outcomes Research Institute (PCORI). Through education and outreach, this nationwide project seeks to empower black women to effectively engage with researchers and clinicians, and to increase participation of black women in cancer-focused clinical trials.