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The influence of race and socioeconomic status on therapeutic clinical trial screening and enrollment

  • Clinical Study
  • Published:
Journal of Neuro-Oncology Aims and scope Submit manuscript

Abstract

Purpose

Under-enrollment in clinical trials significantly limits valid analyses of clinical interventions and generalizability of findings. Often it results in premature study termination, with estimates of 22% to 50% of clinical trials terminated due to poor accrual. Currently, there are limited reports addressing the influence of race/ethnicity and socioeconomic status on clinical trial enrollment in adult glioma patients. The goal of this study was to test the hypothesis that race and socioeconomic status negatively impact therapeutic clinical trial enrollment.

Methods

988 adult patients were identified from the UCSF Tumor Board Registry and analyzed to determine the rate of therapeutic clinical trial screening and study enrollment.

Results

At initial diagnosis, 43.6% and 17.5% of glioma patients were screened and enrolled in a therapeutic clinical trial, respectively. At recurrence, 49.8% and 26.3% of patients were screened and enrolled in a clinical trial, respectively. Thirty-three percent of the study population belonged to a NIH-designated underrepresented minority group; Asian/Pacific-Islander comprised 19.6% of the overall cohort. On univariate analysis, only in-state location, distance to the hospital, and WHO grade were associated with enrollment at initial diagnosis and recurrence. Minority status, insurance type, median household income, and percent below poverty were not associated with clinical trial enrollment.

Conclusion

Minority and socioeconomic status did not impact adult glioma clinical trial enrollment. Proximity to the tertiary care cancer center may be an important consideration for minority patients. Patient screening should be carefully considered in order to avoid bias based on minority and socioeconomic status.

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Acknowledgements

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Funding

This study was funded by Robert Wood Johnson Foundation (Grant No. 74259).

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Author notes

  1. Ramin A. Morshed, Sheantel J. Reihl are co-first authors.

Authors and Affiliations

  1. Department of Neurological Surgery, University of California, 505 Parnassus Ave., Rm. M-779, San Francisco, CA, 94143-0112, USA

    Ramin A. Morshed, Sheantel J. Reihl, Annette M. Molinaro, Sofia Kakaizada, Jacob S. Young, Jessica D. Schulte, Nicholas Butowski, Jennie Taylor, Nancy Ann Bush, Manish K. Aghi, Mitchel S. Berger, Susan Chang, Jennifer Clarke & Shawn L. Hervey-Jumper

  2. Department of Neurology, University of California, San Francisco, CA, USA

    Jennie Taylor, Nancy Ann Bush & Jennifer Clarke

  3. Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA

    Annette M. Molinaro

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  1. Ramin A. Morshed
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Correspondence to Shawn L. Hervey-Jumper.

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Morshed, R.A., Reihl, S.J., Molinaro, A.M. et al. The influence of race and socioeconomic status on therapeutic clinical trial screening and enrollment. J Neurooncol 148, 131–139 (2020). https://doi.org/10.1007/s11060-020-03503-x

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  • DOI: https://doi.org/10.1007/s11060-020-03503-x

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