Lack of Access, Not Lack of Interest, Prevents Black Patients From Enrolling in Clinical Trials

Doctor talking to older black female patient.
Doctor talking to older black female patient.
More than 80% of Black survey respondents said they were somewhat or very likely to consider enrolling in a clinical trial.

Most Black patients with metastatic breast cancer are open to enrolling in clinical trials, but a range of factors may prevent them from participating, a new survey suggests. 

The main barrier to participation was that many survey respondents were not aware of any clinical trials. The respondents also cited barriers to access such as travel time and financial burden, and they expressed concerns about the safety and effectiveness of trial treatments.

These findings, from the BECOME Project, are scheduled to be presented at the 2022 ASCO Annual Meeting and were disclosed in a press briefing in advance of the meeting. 

For this study, researchers surveyed 424 patients with metastatic breast cancer, 102 who self-identified as Black. To develop the survey questions, researchers used information from a literature review and interviews with metastatic breast cancer patients, hospital administrators, and others. 

Overall, 92% of Black survey respondents said they were interested in learning about clinical trials, and 83% said they were somewhat or very likely to consider trial participation. 

However, only 54% of Black respondents said they were aware of metastatic breast cancer trials, 36% said they received adequate information about trials from their care team, and 64% said difficulty finding trials is an important barrier to access. 

Other barriers the respondents cited include too much travel time (47%), too many appointments and tests (40%), centers not taking patients’ insurance (73%), the overall financial burden (56%), and worry about extra medical costs (51%). 

Black respondents also expressed concerns about side effects (73%) and the effectiveness of trial drugs (63%). In fact, Black respondents were more likely than non-Black respondents to believe unstudied treatments may be harmful (57% vs 31%). 

Black respondents were less likely than other respondents to believe that people of all races/ethnicities get fair and equal treatment in trials (32% vs 56%). 

Black respondents were more likely than other respondents to value receiving trial information from someone with the same racial/ethnic identity as them (67% vs 10%), someone who has had breast cancer (73% vs 44%), someone who has had metastatic breast cancer (73% vs 51%), or someone who has participated in a trial (72% vs 48%). 

Based on these results, the researchers concluded that several actions could increase the likelihood that Black patients with metastatic breast cancer will participate in clinical trials. 

Better informing patients, inspiring their trust, ensuring access to trials, and addressing patients’ concerns might all increase the likelihood of participation, according to the researchers.

Disclosures: The BECOME Project is sponsored by the Metastatic Breast Cancer Alliance, a consortium of representatives from nonprofit organizations, pharmaceutical/biotech companies, and patient advocates. Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

Reference

Walker S, Carlson M, White CB, et al. Increasing Black patient participation in metastatic breast cancer clinical trials: The BECOME (Black experience of clinical trials and opportunities for meaningful engagement) project. To be presented at ASCO 2022; June 3-7, 2022. Abstract 1014.

This article originally appeared on Cancer Therapy Advisor