Zhao on Existing Medical Conditions and Cancer Clinical Trial Enrollment

Yayi Zhao, research data analyst, Cancer Epidemiology, Moffitt Cancer Center, discusses how the prevalence of existing medical conditions and clinical factors may vary by race and effect eligibility for enrollment in clinical trials in patients with cancer.

Patients from racial minority groups remain underrepresented in clinical trials, and these patients could be disproportionately affected by restrictive eligibility criteria of these studies. A study presented at the 2023 AACR Annual Meeting examined the prevalence of existing medical conditions by racial groups and their effect on clinical trial enrollment. Investigators conducted a cross-sectional analysis of patients with multiple myeloma, breast cancer, lung cancer, and prostate cancer treated at Moffitt Cancer Center from 2011 to 2021, noting their demographics, existing medical conditions, and lab values.

Results showed that the prevalence of existing medical conditions and clinical factors varied by race, Zhao begins. Specifically, Black patients had a higher prevalence of diabetes, high blood pressure, HIV infections, and organ transplantation compared with White patients. Additionally, Black patients also have a higher prevalence of abnormal lab results, including creatinine levels, neutrophil count, glomerular filtration rate, and aspartate aminotransferase levels, Zhao says.

Additionally, findings for Hispanic patients showed higher rates of existing medical conditions and abnormal lab results compared with non-Hispanic patients, Zhao expands. Zhao and colleagues concluded that the prevalence of existing medical conditions and clinical factors vary by race, and these factors disproportionately impact clinical trial enrollment for racial minority patients.

The study also aimed to gather data on the social determinants of health in these patient groups, Zhao continues. Patients with cancer in a racial minority subgroup were more likely to encounter family difficulties, financial difficulties, transportation issues, and time conflicts with school or work. In addition to existing medical conditions, social determinants of health could be affecting clinical trial enrollment, Zhao concludes.

Investigators are currently participating in the National Cancer Institute-funded research study, ACT WONDER2S, led by Drs. Dana Rollison and Susan Vadaparampil. The aim of the study is to increase trial referrals and enrollment among minority cancer patients in the Moffitt catchment area. The study will employ a multi-level intervention framework to not only target Moffitt Cancer Center patients and physicians, but also community residents (patients) and community physicians.