A five-year community outreach and engagement effort by the Abramson Cancer Center at the University of Pennsylvania (Penn) in Philadelphia to increase enrollment of Black patients into cancer clinical trials more than doubled the percentage of participants, improving access and treatment for a group with historically low representation in cancer research. The percentage of patients enrolled into a treatment clinical trial, for example, increased from 12% to 24%. Significant increases were also observed in non-therapeutic interventional and non-interventional trials.
The findings were published in an abstract to be presented at the American Society of Clinical Oncology annual meeting on June 5.
“An important goal of the Abramson Cancer Center is to serve and engage our community—and that includes improving access to clinical trials for all patients,” said senior author Robert H. Vonderheide, MD, DPhil, director of the center and vice president for cancer programs in the University of Pennsylvania Health System. “Aligning the number of Black patients with cancer we care for with the number enrolled in our trials is how we can help bring more equitable care to the community, close gaps in disparities, and sustain trust. There’s more work to be done to improve access and inclusion of minority groups, and the impact of this outreach and engagement effort is an important step forward.”
Despite making up 13.4% percent of the U.S. population, only 5% of Black patients with cancer are enrolled in clinical trials. Of 8,700 patients who participated in trials nationwide related to the 28 oncology drugs approved by the U.S. Food and Drug Administration (FDA) in 2018 and 2019, only 4% were Black, according to FDA Drug Trial Snapshot reports.
In 2014, Black residents comprised 19% of the population and 16.5% of cancer cases in the 12-county catchment area surrounding Philadelphia, but only 11.1% of patients at the Abramson Cancer Center were Black. The percentages of Black participants accrued into treatment, non-therapeutic interventional, and non-interventional trials at the center were 12.2%, 8.3%, and 13%, respectively.
To address these gaps, the center established a program with community guidance and engagement that included culturally tailored marketing strategies; new partnerships with faith-based organizations serving Black communities to conduct educational events; establishment of a Community Advisory Board and community educational forums; pilot programs with Lyft and Ride Health to address transportation barriers; and patient education by nurse navigators regarding cancer and clinical trials. The center also required that each protocol have a minority accrual plan to obtain approval, and increased access to language-tailored consent forms and translation services for patients.
By 2018, the researchers found that the percentage of Black patients seen at the center had increased to 16.2%. The percentages of Black participants accrued onto treatment, non-therapeutic interventional, and non-interventional trials were 23.9%, 33.1%, and 22.5%, respectively—or 1.7- to 4-fold increases.
Edited by Gary Cramer