ASTRO Annual Meeting
ASTRO Annual Meeting
Perspective from Fumiko Chino, MD
Perspective from Vishal Gupta, MD
Source/Disclosures
Source:

Bero EH, et al. Abstract 204. Presented at: American Society for Radiation Oncology Annual Meeting (virtual); Oct. 25-28, 2020.

Disclosures: Bero reports no relevant financial disclosures. Please see the abstract for all other researchers’ relevant financial disclosures.
October 30, 2020
2 min read
Save

Racial minority groups underrepresented in radiation therapy clinical trials

Perspective from Fumiko Chino, MD
Perspective from Vishal Gupta, MD
Source/Disclosures
Source:

Bero EH, et al. Abstract 204. Presented at: American Society for Radiation Oncology Annual Meeting (virtual); Oct. 25-28, 2020.

Disclosures: Bero reports no relevant financial disclosures. Please see the abstract for all other researchers’ relevant financial disclosures.
You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

The racial diversity of radiation therapy clinical trials did not appear to match that of the 2018 U.S. Census population, according to study results presented at the virtual ASTRO Annual Meeting.

Black patient trial participation was below that expected from the 2018 U.S. Census population in every subgroup analyzed, with the exception of U.S. female-specific cancer trials and male-specific cancer trials. However, our comparison fails to consider differences in incidence between racial populations,” Emily H. Bero, medical student at Medical College of Wisconsin, said during a press conference. “Examining the etiology of inequitable access to clinical trial participation was beyond the scope of our study. Nonetheless, we acknowledge racism as a public health emergency, and we hope this study is informative and offers the opportunity to engage in conversations about race and advancing equitable policies. Structural racism, systemic bias and related barriers consistently limit inclusion of patients from excluded minority groups in clinical trials.”

The racial diversity of radiation therapy clinical trials did not appear to match that of the 2018 U.S. Census population.
The racial diversity of radiation therapy clinical trials did not appear to match that of the 2018 U.S. Census population.

Bero and colleagues pooled data from 121 clinical trials of radiation therapy included on clinicaltrials.gov between 1996 and 2019.

Researchers categorized trials by various subgroups, including U.S.-based (51.6%), radiation therapy toxicity mitigation/prevention (27.9%), female cancer (17.2%) and proton therapy (7.4%). They used chi-square tests to compare the percentages of different racial groups with 2018 U.S. Census population estimates.

Results showed a statistically significant difference between the racial composition of the radiation therapy trials and census estimates (P < .001). The trials combined had a higher percentage of white participants (84.8% vs. 72.2%) and lower percentages of Black participants (11.8% vs. 12.7%) Asian participants (2.9% vs. 5.6%) and participants of other races such as Native Hawaiian, Pacific Islander, American Indian, Alaskan native or more than one race (0.5% vs. 9.5%) compared with census data. Researchers did not examine inclusion of Hispanic patients in trials because ethnicity is a separate census category.

U.S. clinical trials, radiation therapy toxicity mitigation/prevention clinical trials and female cancer clinical trials all had significantly different racial composition compared with census data (P < .001 for all).

The investigators found the most diverse racial composition in female cancer trials (83.3% white, 13.1% Black, 3.4% Asian, 0.3% other) and male cancer trials (80.2% white, 18.4% Black, 1.4% Asian, 0% other), whereas proton therapy trials had the least racial diversity (93.2% white, 6% Black, 0.9% Asian, 0% other).

“When considering all trials, Asian and other excluded populations had the largest magnitudes of difference from the 2018 U.S. Census population data. All differences were statistically significant, and were most pronounced in trials evaluating proton therapy,” Bero said. “This highlights that not only is there inequitable participation on clinical trials, but specific trials using modalities, such as proton therapy, appear to be differentially susceptible to these inequitable distributions. Our findings point to a need for oncologists designing clinical trials and institutions implementing trials to increase inclusion of excluded groups. Efforts to overcome enrollment disparities in radiation trials are important and worthy of continued investigation.”