Departments of Surgical Oncology and Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Department of Internal Medicine, Section of Medical Oncology, and Yale Cancer Center, Yale School of Medicine, New Haven, CT, USA.
J Natl Cancer Inst. 2023 Oct 9;115(10):1132-1138. doi: 10.1093/jnci/djad121.
Many multicenter randomized clinical trials in oncology are conducted through the National Clinical Trials Network (NCTN), an organization consisting of 5 cooperative groups. These groups are made up of multidisciplinary investigators who work collaboratively to conduct trials that test novel therapies and establish best practice for cancer care. Unfortunately, disparities in clinical trial leadership are evident. To examine the current state of diversity, equity, and inclusion across the NCTN, an independent NCTN Task Force for Diversity in Gastrointestinal Oncology was established in 2021, the efforts of which serve as the platform for this commentary. The task force sought to assess existing data on demographics and policies across NCTN groups. Differences in infrastructure and policies were identified across groups as well as a general lack of data regarding the composition of group membership and leadership. In the context of growing momentum around diversity, equity, and inclusion in cancer research, the National Cancer Institute established the Equity and Inclusion Program, which is working to establish benchmark data regarding diversity of representation within the NCTN groups. Pending these data, additional efforts are recommended to address diversity within the NCTN, including standardizing membership, leadership, and publication processes; ensuring diversity of representation across scientific and steering committees; and providing mentorship and training opportunities for women and individuals from underrepresented groups. Intentional and focused efforts are necessary to ensure diversity in clinical trial leadership and to encourage design of trials that are inclusive and representative of the broad population of patients with cancer in the United States.
许多肿瘤学的多中心随机临床试验都是通过国家临床试验网络（NCTN）进行的，该组织由 5 个合作组组成。这些组由多学科研究人员组成，他们合作开展试验，测试新的治疗方法，并为癌症护理制定最佳实践。不幸的是，临床试验领导力的差距显而易见。为了检查 NCTN 内部的多样性、公平性和包容性的现状，2021 年成立了一个独立的 NCTN 胃肠道肿瘤多样性特别工作组，该工作组的努力为本文提供了平台。该工作组试图评估 NCTN 各组成员的现有人口统计和政策数据。发现各组成员之间在基础设施和政策方面存在差异，以及关于组成成员和领导层构成的数据普遍缺乏。在癌症研究中多样性、公平性和包容性的势头日益增强的背景下，美国国家癌症研究所设立了公平和包容计划，该计划正在努力建立关于 NCTN 成员多样性的基准数据。在等待这些数据的同时，建议采取更多措施来解决 NCTN 内部的多样性问题，包括标准化成员、领导和出版流程；确保在科学和指导委员会中具有代表性；并为女性和代表性不足的群体提供指导和培训机会。需要有针对性和有重点的努力来确保临床试验领导力的多样性，并鼓励设计包容性和代表性强的试验，以涵盖美国广大癌症患者群体。
