In a continuation of their collaboration to increase clinical trial participation among patients from underrepresented racial and ethnic groups, ASCO and the Association of Community Cancer Centers (ACCC) recently announced plans to test a research site assessment tool and implicit bias training program, both of which are designed to address one of the barriers to clinical trial participation: trials not routinely being offered by clinicians to eligible patients.1
Lori J. Pierce, MD, FASTRO, FASCO
Randall A. Oyer, MD
This work is part of an ASCO-ACCC initiative to establish evidence-based practical strategies and solutions to help increase participation of people from historically underrepresented racial and ethnic communities in cancer treatment trials. The collaboration—which is led by the ASCO-ACCC Steering Group Co-Chairs, 2020–2021 ASCO President Lori J. Pierce, MD, FASTRO, FASCO, and ACCC Immediate Past President Randall A. Oyer, MD—launched in July 2020 with a Request for Ideas to the oncology community seeking novel innovations to remedy this barrier.
“People with cancer and survivors have told us that whether a clinician discusses a clinical trial is the most important factor for patients considering participation,” said Dr. Pierce. “Providing patients every option of care and treatment empowers them throughout their cancer treatment and helps keep them fully informed about their health. Increasing diversity of trial participants additionally improves the applicability of the results of the clinical trial among diverse populations.”
ASCO and ACCC are currently recruiting over 40 oncology research sites to be a part of a pilot project to test the site assessment tool and/or the implicit bias training program. This initial phase will focus on screening and participation outcomes for patients who are Black and/or Hispanic/Latinx. The assessment tool will evaluate mainly site structural and procedural factors that may impact patient screening and participation. The training will be a curriculum-based program, combined with interventional exercises for enrolling patients, with the opportunity to meet with other participating sites for an interactive, virtual discussion.
Selected sites will comprise a mix of small and large research sites at community- and academic-based oncology programs from diverse regions across the United States. Participating research sites will be offered a stipend for complete participation.
“More evidence is needed to identify factors that contribute to low clinical trial screening and enrollment rates for people with cancer, particularly those from underrepresented racial and ethnic communities,” said Dr. Oyer. “We are developing resources to support practices that want to enhance their screening and enrollment, and these two pilot studies will allow us to gather initial key findings to tackle this issue.”
This trial run of the strategies will help to assess their feasibility and effectiveness across different research settings and will provide insights about their potential to help ensure that cancer treatment trials better reflect the racial and ethnic diversity of people living with cancer.
After the pilot testing, ASCO and ACCC plan to make the resources available to the entire research community.
To learn more about this initiative, visit https://www.asco.org/sites/new-www.asco.org/files/content-files/practice-and-guidelines/documents/2021-asco-accc-faq.pdf.
1. Unger J, Hershman D, Till C, et al: ‘When offered to participate’: A systematic review and meta-analysis of patient agreement to participate in cancer clinical trials. J Natl Cancer Inst 113:244-257, 2021.
© 2021. American Society of Clinical Oncology. All rights reserved.