Angione Angelo, Patterson Jonathan, Akca Ebrar, Xu Jessica, Xu Emily, Raab Vanessa, Elghawy Omar, Barsouk Adam A, Sussman Jonathan H
Department of Neurosurgery, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA.
Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
Life (Basel). 2024 Jul 24;14(8):926. doi: 10.3390/life14080926.
High-grade glioma is the most frequent and lethal primary tumor of the central nervous system. Despite advances in surgical, pharmacological, and cell-directed therapies, there have been no updates to the standard of care in over a decade. This cross-sectional study analyzes patient and trial data from 201 interventional trials completed between 2010 and 2023, encompassing 18,563 participants. Although we found that all trials reported participant age and sex, only 52% of trials reported participant demographics, resulting in 51% of total participant demographics being unreported. The majority of studies did not report ethnicity, with approximately 60% of participants unreported. Additionally, males were significantly underrepresented in trials, comprising 60% of participants despite representing 75% of glioblastoma patients. Improved demographic reporting has been observed since 2011; however, it is inconsistent. Furthermore, we cataloged the geographic diversity of trials across the United States and found significant coverage deserts in relatively rural, but highly affected, areas such as Montana and Maine. We found a wider distribution of trials in both urban and wealthier regions, which indicates extensive coverage gaps and decreased access to participation for patients of a lower socioeconomic status.
高级别胶质瘤是中枢神经系统最常见且致命的原发性肿瘤。尽管在手术、药物和细胞靶向治疗方面取得了进展,但十多年来护理标准一直没有更新。这项横断面研究分析了2010年至2023年间完成的201项介入性试验的患者和试验数据,涉及18563名参与者。虽然我们发现所有试验都报告了参与者的年龄和性别,但只有52%的试验报告了参与者的人口统计学特征,导致51%的总参与者人口统计学特征未被报告。大多数研究没有报告种族,约60%的参与者未被报告。此外,男性在试验中的代表性明显不足,尽管胶质母细胞瘤患者中有75%为男性,但试验参与者中男性仅占60%。自2011年以来,人口统计学报告有所改善;然而,情况并不一致。此外,我们梳理了美国各地试验的地理多样性,发现在相对农村但受影响严重的地区,如蒙大拿州和缅因州,存在明显的试验覆盖空白。我们发现城市和较富裕地区的试验分布更广,这表明存在广泛的覆盖差距,社会经济地位较低的患者参与试验的机会减少。