UChicago Medicine launches study to improve cancer health equity in clinical trials

In the United States, cancer clinical trial participation remains significantly lower for people of diverse race and ethnicity, and people in medically underserved communities. 

At the same time, substantial disparities exist in screening, diagnosis and mortality rates for most cancers. According to 2020 data from the U.S. Food and Drug Administration, 73% of cancer trial participants are white, 14% are Asian, 6% are Hispanic and 5% are Black.

Disparities in clinical trial participation means that Americans from diverse groups may be less likely to benefit from new cancer treatments and the promise of precision medicine. The lack of diverse trial representation also makes it challenging for the healthcare industry to provide evidence-based treatments for all cancer patients. 

A team of researchers at the University of Chicago Medicine have been awarded a grant from Stand Up To Cancer® (SU2C) to determine the most effective ways to increase clinical trial participation among the underserved community on Chicago’s South Side. The 800,000 residents, the majority of whom are Black and historically marginalized, face significantly higher rates of cancer.

“As a patient research advocate, I know how important it is for the Black community to participate in clinical trials. Cancer affects everyone differently and so does treatment. There are new drug therapies that are saving lives — the Black community deserves to have the best quality of life after cancer!” said Kimberly Richardson, founder and executive director of the Black Cancer Collaborative, and two-time cancer survivor.

The UChicago Medicine team is one of four groups in major cities participating in the SU2C Diversity in Early Development Clinical Trials Research Grants Program. As a part of the Health Equity Initiative, the program aims to create unique, replicable approaches that engage underrepresented communities in Phase 1 and Phase 2 cancer clinical trials.

Led by Walter Stadler, MD, and Brisa Aschebrook-Kilfoy, PhD, the team will identify potential trial patients through a method utilizing the electronic health record. The team will then inform the treating physicians which patients are trial candidates prior to each patient's next doctor's visit.

Patients in outreach groups will receive digital communications -- such as electronic health record messaging, email and texts --informing them about clinical trials and the trial process before and after their physician visit.

Physicians for these patients will also receive training on culturally appropriate communication created with community input. Certain patients participating in the study will additionally be given the opportunity to connect with community ambassadors. Nita K. Lee, MD, MPH, and Gina Curry, MPH, MBA, from the UChicago Medicine community engagement team, have established relationships with community-based organizations to identify these ambassadors.

The study will determine if employing new methods of patient outreach — with or without engagement of a community ambassador — increases clinical trial enrollment beyond outreach to the treating physician alone.

“We serve a Black community in particular need of medical services. While we have been successful in our recruitment for clinical trials, we are confident we can do even better with more targeted methods of communication,” Stadler said. 

“We are aiming to enroll three times our current number of diverse clinical trial participants by building trust with patients – through culturally appropriate communication and consistent interactions, both digitally and in person – with our physicians and community-based cancer ambassadors trained to address barriers and concerns relating to trial participation, Stadler said.

A community engagement grant program is accepting applications to support and complement the team’s work. The program will provide two-year grants ranging from $50,000 to $100,000 to Chicago area organizations to develop new or existing community programs focused on diverse cancer clinical trial recruitment.

The grant is supported by a sponsorship from Janssen Pharmaceutical Companies of Johnson & Johnson. The other three research grant recipient teams are based in Dallas, Los Angeles and Philadelphia. Janssen Research & Development, LLC, had input into the selection criteria and how the grant funds will be used. SU2C had the final vote in the selection of the grantees.