Minority populations are underrepresented in clinical trials of pancreatic cancer, and representation has not improved over time, according to research published in Gastroenterology.
Researchers evaluated trends in the representation of minority groups in pancreatic cancer trials between 2005 and 2020. The data encompassed 207 trials including a total of 8429 patients.
Race and ethnicity data were reported in 49.3% and 34.7% of trials, respectively, over the entire study period. In comparison, sex was reported in 99% of trials.
The reporting of race and ethnicity improved significantly over the period studied (P <.0001). For example, with the 2005 trials, race was reported in about 30%, and ethnicity was reported in about 25%. For the 2020 trials, 100% reported race and ethnicity data.
According to the data available, non-White and non-Hispanic patients were underrepresented. White patients made up 84.7% of all trial participants (enrollment fraction [EF], 1.05; P =.002), and non-Hispanic patients made up 90.9% (EF, 1.02; P =.271).
The underrepresented groups included:
- Black patients (8.2%; EF, 0.43; P <.0001)
- Asian/Pacific Islander patients (2.4%; EF, 0; P <.0001)
- American Indian/Alaska Native patients (0.3%; EF, 0; P <.0001)
- Hispanic patients (6%; EF, 0.47, P <.0001).
The researchers noted that trends in racial and ethnic diversity remained relatively unchanged from 2008 through 2020. Furthermore, non-White, Hispanic, and female patients were underrepresented across nearly all phases of trials.
The researchers provided several recommendations for improving representation, including:
- Reevaluating eligibility criteria that might exclude patients from racial and ethnic minority backgrounds
- Increasing diversity of providers and trial coordinators
- Ensuring that sponsors support the inclusion of a diverse patient population
- Reducing bias in trial environments via workforce training
- Conducting trials in locations that are accessible to diverse patient populations
- Continuing patient advocacy and public policy efforts to promote diversity and inclusion.
The researchers stressed that sufficient representation of minorities in future trials will promote the discovery of treatments and methods most likely to benefit a diverse population of patients.
Herremans KM, Riner AN, Winn RA, et al. Diversity and inclusion in pancreatic cancer clinical trials. Gastroenterology. Published online August 17, 2021. doi:10.1053/j.gastro.2021.06.079