1 Sustainable Healthy Communities, Washington, DC.
2 Genentech, South San Francisco, CA.
J Oncol Pract. 2019 Apr;15(4):e289-e299. doi: 10.1200/JOP.18.00638. Epub 2019 Mar 4.
Participation of racial and ethnic minority groups (REMGs) in cancer trials is disproportionately low despite a high prevalence of certain cancers in REMG populations. We aimed to identify notable practices used by leading US cancer centers that facilitate REMG participation in cancer trials.
The National Minority Quality Forum and Sustainable Healthy Communities Diverse Cancer Communities Working Group developed criteria by which to identify eligible US cancer centers-REMGs comprise 10% or more of the catchment area; a 10% to 50% yearly accrual rate of REMGs in cancer trials; and the presence of formal community outreach and diversity enrollment programs. Cancer center leaders were interviewed to ascertain notable practices that facilitate REMG accrual in clinical trials.
Eight cancer centers that met the Communities Working Group criteria were invited to participate in in-depth interviews. Notable strategies for increased REMG accrual to cancer trials were reported across five broad themes: commitment and center leadership, investigator training and mentoring, community engagement, patient engagement, and operational practices. Specific notable practices included increased engagement of health care professionals, the presence of formal processes for obtaining REMG patient/caregiver input on research projects, and engagement of community groups to drive REMG participation. Centers also reported an increase in the allocation of resources to improving health disparities and increased dedication of research staff to REMG engagement.
We have identified notable practices that facilitate increased participation of REMGs in cancer trials. Wide implementation of such strategies across cancer centers is essential to ensure that all populations benefit from advances in an era of increasingly personalized treatment of cancer.
尽管某些癌症在少数民族群体中的发病率较高,但少数民族和族裔群体(REMG)参与癌症试验的比例仍然不成比例地较低。我们旨在确定美国领先癌症中心采用的一些显著做法,以促进 REMG 参与癌症试验。
国家少数民族质量论坛和可持续健康社区多样化癌症社区工作组制定了标准,以确定符合条件的美国癌症中心 - REMG 占该地区的 10%或以上;癌症试验中 REMG 的年入组率为 10%至 50%;并且存在正式的社区外展和多样性招募计划。对癌症中心的领导者进行了访谈,以确定有助于 REMG 在临床试验中入组的显著做法。
符合社区工作组标准的 8 家癌症中心受邀参加深入访谈。报告了五个广泛主题下增加 REMG 参与癌症试验的显著策略:承诺和中心领导、研究人员培训和指导、社区参与、患者参与和运营实践。具体的显著做法包括增加医疗保健专业人员的参与、制定正式程序以获取 REMG 患者/照顾者对研究项目的意见,以及参与社区团体以推动 REMG 参与。中心还报告说,为改善健康差距而分配的资源增加了,研究人员对 REMG 参与的投入也增加了。
我们已经确定了一些显著做法,可以促进 REMG 更多地参与癌症试验。在癌症中心广泛实施这些策略对于确保所有人群都能从癌症个体化治疗时代的进步中受益至关重要。