Karriem S. Watson, DHSc, on Early Engagement in Clinical Trials for Underrepresented Communities
AACR Annual Meeting 2023
Karriem S. Watson, DHSc, MPH, of the National Institutes of Health All of Us Research Program, discusses the importance of engaging in clinical trials for those who are underrepresented in biomedical research. Community engagement is a proven and effective tool, Dr. Watson says, to enhance participation in research by increasing access to and awareness of medical studies and has already been shown to expand the reach of therapies, improving cancer outcomes. (Abstract PL03-05)
Disclaimer: This video transcript has not been proofread or edited and may contain errors.
It is been my pleasure to discuss the importance of diversity in clinical trials. As a cancer disparities researcher and as well as Chief Engagement Officer for the NIH All of Us Research Program, I've seen firsthand what intentional community engagement can do to improve cancer outcomes. I've seen the impact of community-based participatory research as an evidence-based tool to support reaching populations that have been historically underrepresented in biomedical research. We think about populations that carry some of the greatest burden of cancer, such as African-American men. In my research, I've been able to engage African-American men as citizen scientists by working with barbershops, by working with faith leaders as well as members of fraternities and other civic organizations to ensure that we engage members from the community, members that carry the same burden of disease that we see in the populations, that we want to do outreach to engage those partners as equal participants and equal partners in our work.
And it's been through trusted relationship building that we've been able to address and mitigate some of the historical misgivings that have happened, such as when you think about things and studies like those that happened to Henrietta Lacks, when you think about the United States Public Health Service study of syphilis in Tuskegee, Alabama, you think about the historical medical mistrust that has happened. As a result of some of that historical medical mistrust it's important for us to build honest and transparent relationships with people. And through the NIH All of Us Research Program , it's been through these trusted relationships through an engagement ecosystem of over 135 national and local partners that we've been able to build partnerships to address trust, to address transparency, to address things like how do we return value in research, and it's through those trusted partners that we'll be able to advance health disparities research.
Additionally, in my work, I've also looked at some of the ways that we can culturally tailor our educational tools. When you think about a lot of the resources that we have to address cancer disparities, a lot of those resources were not made by, for, nor with populations that carry the greatest burden of disease. In my work, I've found that including the community in both the design, the implementation, as well as dissemination of the research will improve the reach as well as help us to get to mitigating many of those cancer disparities. In the All of Us research program, we've seen firsthand that including community members as partners through intentional community engagement can actually increase the representation of diverse populations in research. We actually have unprecedented numbers of diversity equity inclusion with over 46% of our participants who self-identify as racial and ethnic minorities. And over 80% of our participants are from an underrepresented group in biomedical research. All that has been achieved through direct community engagement.
Jeffrey S. Weber, MD, PhD, of the Perlmutter Cancer Center at New York University Langone, discusses efficacy and safety results from the phase II KEYNOTE-942 trial, which showed that a personalized mRNA-based cancer vaccine, combined with the immune checkpoint inhibitor pembrolizumab, improved recurrence-free survival compared with pembrolizumab alone in patients with high-risk melanoma. The clinical benefit was observed regardless of the tumor mutational burden status. (Abstract CT001)
Harry Klein, PhD, of Dana-Farber Cancer Institute, discusses MatchMiner, a software platform launched in 2017, that matches patients with appropriate clinical trials of targeted therapies. The platform uses data on the genetic features of a patient’s cancer, as well as clinical data, to identify trials at Dana-Farber for which the patient might be eligible. MatchMiner can also help recruit patients who meet the trial’s eligibility requirements. (Abstract 1067)
Sherry X. Yang, MD, PhD, of the National Cancer Institute, discusses findings from the TAILORx trial, which showed that, despite chemotherapy, patients with high recurrence scores continue to have a poor prognosis. This result suggests the need to develop new management strategies for patients with early-stage breast cancer. (Abstract LB119)
Lindsay L. Peterson, MD, of the Washington University, St. Louis, discusses the value of physical activity in improving cancer prognosis, especially for patients with breast or colon cancer. Aerobic exercises and resistance training are recommended during and after treatment. Exercise may help inhibit tumor growth, improve quality of life by decreasing fatigue and anxiety, build muscle mass, increase physical function, and reduce surgical complications and treatment delays.
Pierce K.H. Chow, PhD, MBBS, of the National Cancer Centre, Singapore and Duke-NUS Medical School, discusses phase III findings showing that, for patients with hepatocellular carcinoma at high risk of disease recurrence, adjuvant therapy with atezolizumab plus bevacizumab after resection or thermal ablation was more effective than active surveillance. According to Dr. Chow, these results could lead to reassessment of surgical resection in this disease. (Abstract CT003)