Lymphoma treatments have advanced rapidly, yet only a small percentage of adults with cancer many of whom are of racial and ethnic minorities participate in clinical trials. According to a viewpoint published in Blood Advances, despite making up over 40% of the US population, minority populations represent just 15% of trial participants.
“Underrepresentation of these groups in clinical trials limits the generalizability of clinical trial results and is detrimental to those populations that do not receive equal access to novel therapies,” the authors wrote.
The FDA mandates diversity plans in trial design. Strategies to improve minority enrollment include multidisciplinary tumor boards to identify eligible patients, patient navigators to guide participants, community engagement, modernized eligibility criteria, culturally relevant education, and reduced participation burdens.
Recommended Strategies to Increase Trial Participation
1. Multidisciplinary Tumor Boards (MDTBs): Promote routine patient case reviews to identify clinical trial candidates, improve communication across specialties, and reduce practice variability.
2. Patient Navigators: Guide patients through clinical trial processes, help address logistical and emotional barriers, provide education, and link patients to resources.
3. Community Engagement: Involve community members in trial design and communication, establish partnerships with trusted organizations, and provide transparent, culturally sensitive messaging to overcome mistrust.
4. Modernized Eligibility Criteria: Broaden lab-based thresholds and include patients with comorbidities or organ dysfunction when clinically appropriate.
5. Patient-Centered Support: Improve trial understanding, reduce participation burden (transportation, housing, visit frequency), and connect patients to support services.
6. Implicit Bias and Cultural Competency Training: Educate providers and research teams on social determinants of health and effective communication to foster inclusive trial recruitment.
7. Diverse Workforce Recruitment: Increase racial, ethnic, and language concordance to enhance trust and communication. 8. Regulatory and Administrative Reforms: Streamline processes, standardize trial protocols, and increase support for community-based trial sites to expand reach and equity
