Outcomes Among Racial and Ethnic Minority Patients With Advanced Cancers in Phase 1 Trials: A Meta-Analysis.

Area of Science:

• Oncology
• Clinical Trials
• Health Disparities

Background:

• Racial and ethnic minority groups are underrepresented in cancer clinical trials, particularly phase 1 studies.
• Phase 1 trials offer crucial treatment options for advanced cancer patients progressing on standard therapies.

Purpose of the Study:

• To evaluate if the benefits of phase 1 cancer trial enrollment are comparable for Asian, Hispanic, and non-Hispanic Black patients versus non-Hispanic White patients.

Main Methods:

• A retrospective review of patient records from a single institution (1999-2016) was conducted.
• Data included treatment responses, toxic effects, and deaths from all phase 1 cancer trials.
• Overall survival (OS) was assessed using univariate and multivariable time-to-event analyses, adhering to PRISMA guidelines.

Main Results:

• The study included 738 patients: 197 Hispanic, 238 non-Hispanic Black, and 282 non-Hispanic White patients.
• Median OS was similar across groups: 9.6 months (Hispanic), 8.3 months (non-Hispanic Black), and 9.8 months (non-Hispanic White) (P=.13).
• Factors associated with worse prognosis included older age and poor performance status; leukocytosis was associated with better OS.

Conclusions:

• Hispanic and non-Hispanic Black patients demonstrated similar benefits from phase 1 cancer trial participation compared to non-Hispanic White patients.
• Findings suggest equitable outcomes in this trial setting for minority populations.
• Further research should focus on improving minority representation in early-phase cancer trials.