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Updated: Jan 10, 2026

A Bioluminescent and Fluorescent Orthotopic Syngeneic Murine Model of Androgen-dependent and Castration-resistant Prostate Cancer
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Under-Representation of Black and Hispanic Men in Metastatic Castration-Resistant Prostate Cancer Trials (2005-2021):

Canan D Dirican1, Sagar Patel2, Anas Al Mardini1

  • 1NYMC Internal Medicine Residency Program at Saint Mary's and Saint Clare's, Denville, NJ.

JCO Oncology Practice
|November 24, 2025
PubMed
Abstract

Insights

Black men face high prostate cancer burdens but are underrepresented in clinical trials. Their participation in metastatic castration-resistant prostate cancer trials has declined, highlighting a need for improved trial diversity.

Area of Science:

  • Oncology
  • Clinical Trials
  • Health Disparities

Background:

  • Black men experience the highest prostate cancer incidence and mortality rates globally.
  • Metastatic castration-resistant prostate cancer (mCRPC) disproportionately affects this population.
  • Clinical trials often lack adequate representation of key demographic groups.

Purpose of the Study:

  • To evaluate representation trends of racial and ethnic groups in mCRPC clinical trials over a 17-year period.
  • To assess changes in participant demographics in mCRPC trials from 2005 to 2021.

Main Methods:

  • Analysis of 33 phase III and IV mCRPC trials registered on ClinicalTrials.gov (2005-2021).
  • Extraction of data on participant race, ethnicity, and trial geography.
  • Assessment of representation trends over time and by funding source, using a random-effects model for pooled demographics.

Main Results:

  • Only 73% of trials reported race and 42% reported ethnicity.
  • White participants constituted 79.2%, Asian 10.8%, and Black or African American participants only 3.8%.
  • Black participation decreased from 13.7% to 3% during the study period; trials were geographically limited to North America and Europe.

Conclusions:

  • Profound racial and ethnic under-representation persists and has worsened in mCRPC trials.
  • There is a critical need for structural reforms in trial design, funding, and regulatory oversight.
  • Equitable access to and generalizability of prostate cancer therapies require improved trial inclusivity.

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