ASCO Voices speakers, selected by audition to share personal experiences relating to the annual meeting theme, included Neal Meropol, MD, who identified logistics as one of the greatest impediments to clinical trial participation. Travel to academic centers may be expensive for some and impossible for those in rural communities. Those who do participate tend to be younger, more educated, wealthier, whiter, and with fewer comorbidities, and are therefore not representative of the overall population with cancer.
To make it possible for patients to access trials wherever they receive their care, rendering clinical research routine, data already in EHRs, representing 70% of the information needed for trials, could be transferred directly to study databases. Facilitating the participation of a more diverse population would yield more generalizable trial results.
Khamai Simpson, MSc, a patient engagement manager, also addressed equity in clinical trials access, noting that many people of color are not even informed of the existence of an appropriate trial. “Systematically informing all patients about trials at diagnosis, no matter what they look like and no matter what their educational background may be, is one of the best ways to ensure health equity in clinical trial access,” she said.
Louise Brennan, PhD, a research fellow and physical therapist, described how the coronavirus pandemic forced the creation of a pilot online cancer rehabilitation research program to replace a grant-funded in-person program. The global population of cancer survivors is growing, and many who could benefit from exercise, nutrition, survivorship, and related counseling, have not received it. Dr. Brennan’s group showed that providing technical support and equipment led to improved fitness and nutrition for participants, and without geographic constraints or interference with work or family obligations.
“It became clear to us that many of the challenges that we historically had with recruitment and accessing our studies could be resolved using digital technologies,” she said, observing that when they were able to restart their randomized clinical trial, they changed to a hybrid model with in-person and online options. “As researchers, it's our responsibility to design studies which actively promote inclusion and equality of access.”
Dr. Lederman has no conflicts of interest to report.
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