Compared with the non-Hispanic White population, Hispanic and Black adolescents and young adults (AYA) with acute lymphoblastic leukemia (ALL) experience significantly inferior outcomes. In an analysis of the CALGB 10403 AYA trial presented at the recent American Society of Hematology (ASH) 63rd Annual Meeting & Exposition in Atlanta, Georgia, a team of researchers led by Dr. Lori Muffly, Associate Professor of Medicine at Stanford University, investigated racial and ethnic disparities in clinical trial enrollment and found a lower enrollment of Hispanic and Black patients proportional to the overall AYA ALL population. In addition, the researchers found that closer matching of trial site selection to geographic racial/ethnic disease incidence may decrease racial disparities in multicenter clinical trials. In this interview with Oncology Data Advisor, Dr. Muffly explains the large-scale steps aimed at reducing racial and ethnic disparities in clinical trial enrollment for acute lymphoblastic leukemia.
Oncology Data Advisor: In light of your results, what would you say are the next steps in reducing racial and ethnic disparities in ALL clinical trial enrollment?
Dr. Lori Muffly: I think that there's not going to be one single answer to the problem. We need to think about the different reasons for disparities in clinical trial enrollment in general. What our study focused on was where clinical trials were open and how geographical enrollment patterns and cancer incidence can affect trial enrollment.
One of the things I would like to see change, which would take place when we're developing trials, whether with cooperative groups or industry, is taking the disease incidence into account when the trial is being designed. If we want the trial to reflect the true cancer population in ALL, for example, we really need to have that mindset from the beginning and open our trials in areas where Hispanic patients live.
About Dr. Muffly
Lori Muffly, MD, MS, is a blood and marrow transplant specialist at Stanford Health Care and an Associate Professor of Medicine in the Division of Blood and Marrow Transplantation and Cellular Therapy at Stanford University. In addition, she is the Clinical Research Group Leader for Stanford Blood and Marrow Transplant (BMT), the Clinical Research Operations Leader for the Stanford BMT-Cellular Therapy (CT) Division, and the Co-Chair of the Bone Marrow Transplant Clinical Trials Network Publications Committee. Dr. Muffly specializes in the treatment of patients with acute leukemia, with particular expertise in blood and marrow transplants and cellular therapies. She is actively involved in clinical research to improve outcomes in acute leukemia, and she has authored or coauthored numerous publications in peer-reviewed journals.
For More Information
Muffly, L, Yin J, Jacobson S, et al (2022). Enrollment characteristics and outcomes of Hispanic and Black AYA ALL patients enrolled on a U.S. Intergroup clinical trial: a comparison of the CALGB 10403 (Alliance) cohort with U.S. population-level data [oral presentation]. 63rd American Society of Hematology Meeting & Exposition. Abstract 337.
Transcript edited for clarity. Any views expressed above are the speaker's own and do not necessarily reflect those of Oncology Data Advisor.