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Rebecca Olin, MD, MS


Clinical Trials in Acute Leukemia: Targeting Participatory Inequities

By: Joseph Fanelli
Posted: Thursday, September 15, 2022

According to findings presented in the Journal of Clinical Oncology, research disparities among White and non-White persons with acute leukemia are substantial and driven by structural trial enrollment barriers at comprehensive cancer centers. Andrew Hantel, MD, of the Dana-Farber Cancer Institute, Boston, and colleagues concluded that real-time comprehensive cancer center access and enrollment monitoring is needed to improve research participation with local populations.

“Reasonable next steps for improving participatory equity include integrating institutional and registry data sets to understand barriers between the catchment area, [comprehensive cancer center], and trial; trial-embedded collection of social determinant data; and further developing community-engaged interventions for historically marginalized groups,” the authors said.

In this trial, the authors analyzed enrollee characteristics from 15 Cancer and Leukemia Group B/Alliance cooperative group adult leukemia clinical trials from 1998 to 2013. The population pool included 3,734 people.

The investigators found that non-Hispanic White patients were more likely to be enrolled in trials than non-Hispanic Black, non-Hispanic Asian, or Hispanic patients, although they were less likely to be enrolled than non-Hispanic Native American patients, when adjusted for national incidence. The enrollment odds for non-Hispanic Black, non-Hispanic Asian, and Hispanic patients at comprehensive cancer centers were lower when considering catchment area incidences. The authors noted that the differences among race and ethnicity appeared to be driven by overenrollment of non-Hispanic White patients from outside self-defined catchment areas and by comprehensive cancer centers with less absolute enrollee diversity. For comprehensive cancer centers, the correlation of race/ethnicity with biobank participants was attenuated by a measure accounting for the site’s degree of enrollment disparity but not neighborhood deprivation.

Disclosure: For full disclosures of the study authors, visit

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