Understanding disparities in pediatric solid tumor oncology trial enrollment
Mentor: Andrew Hong
We have made significant improvements in the outcomes of our patients with pediatric cancers. However, most of our trials are restricted to English speaking participants and our understanding of how a patient or their legal guardian decides to enroll on a clinical trial remains somewhat limited. Especially as we are aiming to ensure that all our children have access to all trials and that our trials represent the diversity of our country, it is critical that we first understand where we are starting. Recent studies have shown that Hispanic patients with acute lymphoblastic or myeloid leukemia have inferior outcomes when compared with non-Hispanic Caucasian patients due in part to language barriers or cultural differences (Bhatia, 2011; Aplenc et al., 2006). Further, other factors contributing to disparities in cancer outcomes include socioeconomic status (SES) and geographic location. As such, there is a need to understand these barriers to ensure equitable inclusion of our patients in clinical trials.
The project goal for during the POST Award is to develop a database of our patients seen at Children’s Healthcare of Atlanta since institution of electronic records (e.g., 2009-present) which focuses on the patients’ diagnoses, languages, race and ethnicity, home zip code (based on ARC GIS). This will be cross referenced with what clinical trials through Children’s Oncology Group were open and to determine if enrollment rates are different by race and ethnicity. As work has already commenced in patients with leukemia and lymphoma, this project will focus on Wilms Tumor, neuroblastoma and medulloblastoma. We hypothesize that underrepresented minorities will have enrolled at lower rates than non-Hispanic Caucasians.
